ELEVATED PROGESTERONE LEVELS IN THE LATE FOLLICULAR PHASE DO NOT PREDICT SUCCESS OF IN-VITRO FERTILIZATION-EMBRYO TRANSFER

Objective: To examine the effects of subtle elevation in P levels in l ate follicular phase on the outcome of IVF-ET cycles, using GnRH agoni st (GnRH-a) and hMG +/- FSH protocol. Design: A retrospective analysis of data. Setting: Tertiary care teaching medical center. Patients: Fi fty-four patients who completed 63 IVF-ET cycles were treated with mid luteal GnRH-a, followed by hMG +/- pure FSH. Depending on serum P leve ls on the day of hCG administration, patients were divided into two gr oups. In group 1, P levels were less than or equal to 0.9 ng/mL (conve rsion factor to SI unit, 3.180) and in group 2, the levels were >0.9 n g/mL. Results: Luteinizing hormone levels, on the day of hCG administr ation, as measured by RIA, were suppressed completely. In cycles with subtle P rise (71%), we observed a significantly higher serum E(2) con centration, greater number of mature follicles, and greater number of oocytes retrieved: There were no differences between the two groups in fertilization rate, number of embryos transferred, clinical pregnancy rate, implantation rate, and miscarriage or delivery rates. Conclusio ns: We conclude that in IVF-ET cycles, when pretreated with GnRH-a, P levels may increase on the day of hCG administration despite LH suppre ssion and such elevation may not affect adversely the final outcome.