Abstract

OBJECTIVE
To assess the impact of pre-hCG elevated progesterone on live birth outcomes during GnRH agonist long down regulated protocol assisted reproduction cycles.
DESIGN
Retrospective cohort study.
SETTING
Single Centre Private IVF Clinic.
PATIENTS
A total of 582 consecutive cycles of IVF/ICSI in 2003.
INTERVENTIONS
All patients underwent a long down-regulation protocol, controlled ovarian stimulation and IVF/ICSI. Serum progesterone concentrations were measured just prior to HCG administration. 253 patients were followed to 2009 for outcomes of their frozen embryo cycles.
MAIN OUTCOME MEASURE
Live birth rate in fresh and frozen cycles.
RESULTS
Patients in the upper quartile pre-hCG progesterone concentration (≥ 5.4 pmol/L) had a higher final estradiol level, more oocytes collected and more usable embryos, when compared to those with lower quartiles. They also had lower live birth rates per cycle started (21.9% vs. 15%, P < 0.05). However, live birth rates from frozen embryo cycles were not significantly different between the groups.
CONCLUSIONS
Pre-hCG progesterone elevation leads to lower live birth rates in stimulated IVF cycles. Live birth rates achieved with frozen embryos in the high progesterone cycles suggest, that pre-hCG progesterone elevation negatively affects endometrial receptivity without adversely affecting embryo quality.

Links

Publisher Full Text

Authors

Lahoud R, Kwik M, Ryan J, Al-Jefout M, Foley J, Illingworth P

Institution

IVF Australia, 176 Pacific Highway, Greenwich, Sydney, NSW 2065, Australia. rlahoud@ivf.com.au

Source

Archives of gynecology and obstetrics 285:2 2012 Feb pg 535-40

MeSH

Adult
Blastocyst
Cryopreservation
Embryo Implantation
Embryo Transfer
Female
Fertility Agents, Female
Fertilization in Vitro
Gonadotropin-Releasing Hormone
Humans
Live Birth
Nafarelin
Pregnancy
Pregnancy Rate
Progesterone
Retrospective Studies
Young Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21853250