Elevated progesterone in GnRH agonist down regulated in vitro fertilisation (IVFICSI) cycles reduces live birth rates but not embryo quality.

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.

journal_name

Arch Gynecol Obstet

authors

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

doi

10.1007/s00404-011-2045-0

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

535-40

issue

2

eissn

0932-0067

issn

1432-0711

journal_volume

285

pub_type

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