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Are good patient and embryo characteristics protective against the negative effect of elevated progesterone level on the day of oocyte maturation?

Abstract：

OBJECTIVE:To evaluate if an elevated progesterone (P) level on the day of human chorionic gonadotropin (hCG) administration is associated with a decrease in live-birth rate in patients with a good prognosis. DESIGN:Retrospective cohort study. SETTING:Large, private, assisted reproductive technology (ART) practice. PATIENT(S):One thousand six hundred twenty fresh autologous ART cycles. INTERVENTION(S):None. MAIN OUTCOME MEASURE(S):Live-birth rate. RESULT(S):A total of 934 blastocyst and 686 cleavage-stage embryo transfer (ET) cycles were evaluated. Serum P levels were not associated with markers of oocyte or embryo quality, including fertilization, embryo stage at transfer, and embryos available for cryopreservation. Patient age, stage of ET, embryo quality, the number of embryos transferred, and P level on the day of hCG administration were all significantly associated with live birth. Higher P levels were associated with decreased odds of live birth for cleavage- and blastocyst-stage embryos, poor-fair and good-quality embryos, and poor- and high-responder patients. The nonsignificance of interaction tests of P levels with embryo stage, embryo quality, patient age, and ovarian response indicated that the relationship between P level and live birth was similar regardless of these factors. CONCLUSION(S):An elevated serum P level on the day of hCG administration was negatively associated with live birth, even in ETs with a good prognosis.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Hill MJ,Royster GD 4th,Healy MW,Richter KS,Levy G,DeCherney AH,Levens ED,Suthar G,Widra E,Levy MJ

doi

10.1016/j.fertnstert.2015.02.038

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

1477-84.e1-5

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(15)00168-5

journal_volume

103

pub_type

杂志文章

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