ELEVATED SERUM PROGESTERONE LEVELS ON THE DAY OF HUMAN CHORIONIC-GONADOTROPIN ADMINISTRATION DO NOT PREDICT OUTCOME IN ASSISTED REPRODUCTION CYCLES

Objective: To determine if the level of serum P drawn on the day of hC G administration predicts assisted reproductive technology (ART) outco me in patients undergoing stimulation with hMG under GnRH agonist (GnR H-a) suppression. Design: Retrospective P assay of stored serum. Patie nts: One hundred seventy-one patients (189 cycles) who had undergone G nRH-a suppression (leuprolide acetate or nafarelin) and stimulation wi th hMG for an ART procedure. Main Outcome Measures: Progesterone RIA o f serum obtained on the day of hCG administration. Measurement of sequ ential serum LH values by RIA in those patients with the highest P lev els. Results: Pregnancy rates per oocyte retrieval were not correlated with the P level before hCG administration. There were 18 of 54 (33.3 %) clinical pregnancies in those cycles with P < 0.9 ng/mL (conversion factor to SI unit, 3.180) and 42 of 135 (31.1%) clinical pregnancies in cycles with a P greater than or equal to 0.9 ng/mL. Significantly h igher serum E(2) levels and numbers of follicles and oocytes obtained were observed in the high P cycles. There were no differences in the n umber of oocytes fertilized, the number of embryos transferred or the implantation rate. However, a significantly higher percentage of matur e oocytes were fertilized in the low P cycles (73%), as compared with the high P cycles (60%). Conclusions: Serum P levels before hCG admini stration do not predict the outcome of ART cycles in patients suppress ed with GnRH-a before hMG stimulation. Lower fertilization rates obser ved in the high P cycles did not have an effect on clinical outcome.