HIGH PROGESTERONE LEVELS ADVERSELY AFFECT EMBRYO QUALITY AND PREGNANCY RATES IN IN-VITRO FERTILIZATION AND OOCYTE DONATION PROGRAMS

Objective: To assess the effect of P levels on oocyte and embryo quali ty and pregnancy rates (PRs) in IVF and oocyte donation. Design: Retro spective analysis of PRs in ovum donors and their recipients with rega rd to P levels on day of hCG administration. Setting: In vitro Fertili zation Units, oocyte donation programs. Patients: In vitro fertilizati on patients who agreed to donate oocytes were treated by hMG alone (53 cycles) or in combination with a GnRH analog (122 cycles). Interventi ons: Uterine preparation in oocyte recipients consisted of 6 mg/d E(2) valerate. Progesterone (100 mg/d) was added when oocytes became avail able. Hormonal treatment was continued until 12 weeks of gestation. Re sults: Using a series of Fisher's Exact Tests, a critical threshold fo r P was identified at 1.9 ng/mL (conversion factor to SI units, 3.185) . With elevated P levels (>1.9 ng/mL), lower PRs were noted for the do nors (7.1% versus 17%), as well for the recipients (8.3% versus 26.7%) . Conclusions: Exposure to elevated P levels resulted in lower PRs for the donors and significantly lower PRs in the recipients. Because the endometria in the recipients were prepared uniformly, we conclude tha t this is the result of detrimental effects of P on oocyte or embryo q uality.