A. Shechter et al., THE SIGNIFICANCE OF SERUM PROGESTERONE LEVELS ON THE DAY OF HCG ADMINISTRATION ON IVF PREGNANCY RATES, Gynecological endocrinology, 8(2), 1994, pp. 89-94
The aim of the present study was to evaluate the relationship between
serum progesterone level on the day of human chorionic gonadotropin (h
CG) administration (day 0) and pregnancy rate among patients undergoin
g in vitro fertilization and embryo transfer. Serum progesterone level
s were analyzed retrospectively in 160 cycles. In 56 women ovarian sti
mulation was induced by gonadotropins only (group A). In 104 cases a g
onadotropin releasing hormone (GnRH) analog was given prior to gonadot
ropin administration (group B). At least three embryos were transferre
d in all cases. A significantly (p < 0.01) higher serum progesterone l
evel (greater-than-or-equal-to 1 ng/ml) on day 0 was observed in the 4
3 patients of group A who did not conceive compared with the 13 who co
nceived. No significant difference in serum progesterone levels on day
0 was found between the 37 patients of group B who conceived and the
67 who did not. The pregnancy rate (0.36) in group B was significantly
(p < 0.05) higher than that in group A (0.23). However, the pregnancy
rate (0.35) in patients in group A with low progesterone levels (less
-than-or-equal-to 1 ng/ml) was not significantly lower than that in gr
oup B. We demonstrated that elevated progesterone levels (less-than-or
-equal-to 1 ng/ml) on day 0 in patients receiving stim lation with gon
adotropin only, might be detrimental to pregnancy. In view of these re
sults, we suggest that early oocyte retrieval should be considered in
patients whose progesterone level on the day of hCG administration exc
eeds 1 ng/ml following stimulation with gonadotropin only.