Does progesterone to oocyte index have a predictive value for IVF outcome? A retrospective cohort and review of the literature

Abstract

The potential adverse effect of Serum progesterone (SP) elevation on the day of hCG administration is a matter of continued debate. Our study aimed to evaluate the relative value of progesterone to a number of aspirated oocytes ratio (POI) to predict clinical pregnancy (CP) and live birth (LB) in fresh IVF cycles and to review the relevant literature. A retrospective analysis of GnRH Antagonist IVF-ET cycles. POI was calculated by dividing the SP on the day of hCG by the number of aspirated mature oocytes. A multivariate logistic regression analysis was performed to evaluate the predictive value of POI for CP and LB. Cycle outcome parameters included clinical pregnancy, live-birth and miscarriage. A total of 2,693 IVF/ICSI cycles were analyzed. POI was inversely associated with CP adjusted OR 0.063 (95% CI 0.016–0.249, p < .001) and with LB adjusted OR 0.036 (95% CI 0.007–0.199, p < .001). For prediction of LB, the area under the curve (AUC) was 0.68 (95% CI 0.64–0.71, p < .001) for the POI model. POI above the 90th percentile with a value of 0.36 ng/mL/oocyte results in CP and LB rates of 8.0 and 5.9%, respectively. POI is a simple index for the prediction of IVF-ET cycle outcomes, it can advocate a limit above which embryo transfer should be reconsidered.

Chinese abstract

卵母细胞的孕激素有预测体外受精结果的价值吗？回顾性队列和文献回顾

摘要

血清孕酮(SP)升高对hCG的影响是一个持续争论的问题。我们的研究目的是评估孕酮在体外受精周期的临床妊娠(CP)和活产(LB)的相对价值, 并回顾关于GnRH拮抗IVF-ET周期的相关回顾性分析。当hCG出现时, 用SP除以成熟卵母细胞数, 得到POI。采用多元logistic回归分析评估POI对临床妊娠和活产的预测价值。循环输出参数包括临床妊娠、活体分娩和流产。共分析了2693个IVF或ICSI循环。POI与调整OR0.063后的CP (95% CI 0.016-0.249, p < 0.001)和调整OR0.036后的LB (95% CI 0.007-0.199, p < 0.001)呈负相关。对于LB的预测, POI模型曲线下面积(AUC)为0.68 (95% CI 0.64-0.71, p < 0.001)。POI第90百分位数值为0.36 ng/mL/卵母细胞, CP和LB的比率分别为8.0和5.9%。POI是预测IVF-ET周期结果的一个简单指标, 它可以提倡在超过这个限度的情况下重新考虑胚胎移植。

关键词: 孕酮; IVF; 卵泡; 卵母细胞;孕酮-卵母细胞指数（ POI）

Keywords:

• Progesterone
• IVF
• follicle
• oocyte
• progesterone–oocyte index

Disclosure statement

No potential conflict of interest was reported by the authors.