The value of serum progesterone level on day of human chorionic gonadotrophin administration / metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve

Mahran, Ahmad; Khairy, Mohammed; Elkhateeb, Reham; Hegazy, AbdelRahman; Abdelmeged, Ayman; Batiha, Gaber El‐Saber; Alsharif, Khalaf F.; Hetta, Helal F; Bahaa, Haitham Ahmed

doi:10.1186/s13048-021-00800-5

Cited by 9 publications

(9 citation statements)

References 30 publications

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“…Therefore, the effect of elevated P levels on clinical outcomes may vary in different ovarian responders. Due to differences in populations, races, protocols, etc., the currently reported elevated P values are not uniform ( 13 , 19 , 20 ).…”

Section: Introductionmentioning

confidence: 72%

“…( 32 ) set the limit of the hCG daily P level to 1.5 ng/ml, which is widely used in clinical practice. However, studies show that when P>1 ng/ml, the CPR or LBR decreases ( 13 , 19 , 23 ). Only people with normal ovarian response with GnRH antagonist protocols were included for analysis in our study, and P>1 ng/ml affected the LBR of fresh embryo transfer.…”

Section: Discussionmentioning

confidence: 99%

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Effect of serum progesterone levels on hCG trigger day on pregnancy outcomes in GnRH antagonist cycles

Zhang

Du²,

Wu³

et al. 2022

Front. Endocrinol.

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ObjectiveThe present study analyzed the effect of hCG trigger day progesterone (P) levels on the live birth rate (LBR) in the gonadotropin-releasing hormone (GnRH) antagonist protocol.Materials and methodsThis study was a single-center retrospective study. In vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles performed from January 2017 to December 2020 were included in the analysis. This study included people with a normal ovarian response to fresh embryo transfer of GnRH antagonist protocols. All cycles were divided into 2 groups by P level on the day of human chorionic gonadotropin (hCG) trigger, P<1.0 ng/ml and P≥1.0 ng/ml. The primary outcome measure was LBR.ResultA total of 867 cycles with P<1.0 ng/ml and 362 cycles with P≥1.0 ng/ml were included in the analysis. The clinical pregnancy rate (CPR) was higher in the P<1.0 ng/ml group than the P≥1.0 ng/ml group (44.9% vs. 37.6%, P=0.02). The early spontaneous abortion rate was comparable between the groups (14.4% vs. 14.7%, P=0.93). For live birth, the rate for the P<1.0 ng/ml group was 35.3%, which was significantly higher than the 29.0% in the P≥1.0 ng/ml group (P=0.03). After binary logistic regression analysis, the P level on the hCG trigger day (adjusted odds ratio=0.74, 95% CI=0.55-0.99, P=0.04) was an independent risk factor for LBR. For the P level on the hCG trigger day, the LBR was lower in the P≥1.0 ng/ml group compared to the P<1.0 ng/ml group.ConclusionFor normal ovarian response patients using the GnRH antagonist protocol, serum P≥1.0 ng/ml on the hCG trigger day resulted in a lower LBR than the P<1.0 ng/ml group. When P≥1.0 ng/ml, whole embryo freezing may be considered.

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Section: Introductionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Effect of serum progesterone levels on hCG trigger day on pregnancy outcomes in GnRH antagonist cycles

Zhang

Du²,

Wu³

et al. 2022

Front. Endocrinol.

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“…Previous research suggested the MII oocytes rate from large follicles is significantly higher than from small follicles [ 13 ]. MII oocyte rate rather than the number of oocytes retrieved is a more accurate predictor of implantation and clinical pregnancy in IVF cycles [ 14 ]. FOI is defined as the ratio between the number of oocytes collected at the oocyte retrieval and AFC at the beginning of ovarian stimulation.…”

Section: Discussionmentioning

confidence: 99%

Nomogram based on clinical and laboratory characteristics of euploid embryos using the data in PGT-A: a euploid-prediction model

Liu

2022

BMC Pregnancy Childbirth

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Background The evaluation of embryo morphology may be inaccurate. A euploid prediction model is needed to provide the best and individualized counseling about embryo selection based on patients and embryo characteristics. Methods Our objective was to develop a euploid-prediction model for evaluating blastocyst embryos, based on data from a large cohort of patients undergoing pre-implantation genetic testing for aneuploidy (PGT-A). This retrospective, single-center cohort study included data from 1610 blastocysts which were performed PGT-A with known genetic outcomes. The study population was divided into the training and validation cohorts in a 3:1 ratio. The performance of the euploid-prediction model was quantified using the area under the receiver operating characteristic (ROC) curve (AUC). In addition, a nomogram was drawn to provide quantitative and convenient tools in predicting euploid. Results We developed a reliable euploid-prediction model and can directly assess the probability of euploid with the AUC (95%CI) of 0.859 (0.834,0.872) in the training cohort, and 0.852 (0.831,0.879) in the validation cohort, respectively. The euploid-prediction model showed sensitivities of 0.903 and specificities of 0.578. Conclusions The euploid-prediction model is a reliable prediction model and can directly assess the probability of euploid.

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“…Many studies have shown that progesterone produced in IVF/ICSI is related to the number of follicles ( 23 , 24 ). In this study, we hypothesised that late elevations in follicular blood progesterone might be owing to the following reasons: 1) An increase in progesterone secretion from the recruited follicles; the greater the number of follicles, the higher the progesterone level, which could be induced by any protocol; 2) pathological progestogen, which is related to the premature luteinisation of follicles and decreased follicle quality.…”

Section: Discussionmentioning

confidence: 99%

Letrozole Supplementation and the Increased Risk of Elevated Progesterone Levels on Trigger Day

Liu

Li-ling

et al. 2022

Front. Endocrinol.

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Although using letrozole (LE) during in vitro fertilisation and intracytoplasmic sperm injection (IVF/ICSI) has many advantages, it remains unclear whether LE induces an increase in progestogen during the late follicular phase. The objective of this study was to investigate whether progesterone levels increased under antagonist protocols supplemented with LE on the trigger day using a retrospective cohort study. The study included 1,133 women who underwent IVF/ICSI cycles from January 2018 to June 2020. After propensity score matching (PSM) for baseline characteristics, 266 patients with gonadotropin-releasing hormone-antagonist (GnRH-ant) were matched to 266 patients with letrozole + GnRH-ant (LE GnRH-ant) (PSM 1 cohort), and 283 patients with gonadotropin-releasing hormone-agonist (GnRH-a) were matched to 283 patients with LE GnRH-ant (PSM 2 cohort). In the PSM 1 cohort, patients in the LE GnRH-a group presented higher progesterone levels (1.22 ± 0.95 ng/mL vs 0.86 ± 0.60 ng/mL, P < 0.001), with a higher proportion of patients with progesterone level > 1.5 ng/mL (24.81% vs 7.52%, P < 0.001). In PSM 2 cohort, patients in the LE GnRH-a group presented higher progesterone levels on trigger day (1.23 ± 0.91 ng/mL vs 0.98 ± 0.61 ng/mL, P < 0.001), with a higher proportion of patients with progesterone level > 1.5 ng/mL (25.45% vs 12.70%, P < 0.001). In the PSM 1 cohort, progesterone levels on the trigger day increased by 0.05 ng/mL, with an increase in every retrieved oocyte in the LE GnRH-ant group (β 0.05 ng/mL [95% CI 0.04, 0.06], P < 0.001), whereas an increase of 0.02 ng/mL was observed in the GnRH-ant group (β 0.02 ng/mL [95% CI 0.01, 0.03], P < 0.001), with P for interaction being 0.0018. In the PSM 2 cohort, progesterone levels on the trigger day increased by 0.05 ng/mL with an increase in every retrieved oocyte in the LE GnRH-ant group (β 0.05 ng/mL [95% CI 0.04, 0.06], P < 0.001), whereas an increase of 0.02 ng/mL was observed in the GnRH-a group (β 0.02 ng/mL [95% CI 0.01, 0.03], P < 0.001), with P for interaction being 0.0002. LE supplementation on the antagonist protocols may increase progesterone levels in the late follicular stage.

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The value of serum progesterone level on day of human chorionic gonadotrophin administration / metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve

Cited by 9 publications

References 30 publications

Effect of serum progesterone levels on hCG trigger day on pregnancy outcomes in GnRH antagonist cycles

Effect of serum progesterone levels on hCG trigger day on pregnancy outcomes in GnRH antagonist cycles

Nomogram based on clinical and laboratory characteristics of euploid embryos using the data in PGT-A: a euploid-prediction model

Letrozole Supplementation and the Increased Risk of Elevated Progesterone Levels on Trigger Day

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