Abstract
Purpose
The study was designed to evaluate the relationship between serum progesterone (P4) response after hCG administration and the number of oocytes retrieved and the embryo quality in fresh IVF cycles.
Methods
We conducted a retrospective cohort study of women aged 24–43 years who underwent first fresh IVF cycle from 2011 to 2013 at a single practice. We compared the post-hCG serum P4 level with values on the day of hCG trigger. Patients were analyzed in long and short protocols independently. In addition, patients were stratified by post-hCG P4 response. Number of oocytes retrieved and embryo quality were the primary outcomes of interest. Ordinary least square regression models and logistic regression analysis models were created to identify predictive factors associated with embryological outcomes while adjusting for potential confounders.
Results
Among the 2,978 IVF cycles, 2,484 patients were in long protocols, and 494 patients were in short protocols. After adjusting for patient age, rFSH duration, and basal FSH levels, the associations between P4 response after hCG administration and number of oocytes retrieved (P < 0.001) remained statistically significant in both long and short protocols. Additionally, mature oocyte rate, fertilization rate, good quality embryo rate, pregnancy rate and implantation rate were not significantly associated with the P4 increase when adjusting for the same factors. However, pregnancy rate and implantation rate from frozen-thawed cycles increased gradually across the seven groups.
Conclusions
Post-hCG P4 levels were positively associated with the number of oocytes retrieved, but did not affect oocyte or embryo quality. Our study suggests that the change in the post-hCG P4 level is another parameter that can be used by clinicians to assess the number of oocytes retrieved, and may further to estimate the pregnancy rate and live birth rate indirectly.
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Acknowledgments
The authors sincerely thank other investigators and physicians who made contributions to this study. This work was supported by grants from the National Natural Science Foundation of China (No. 81270657), the Science and Technology Department Program of Zhejiang (2013C33145), the health department Program of Zhejiang (No. 2012RCA036) and the Natural Science Program of Zhejiang (Y14H040012). There is no conflict of interest in this article.
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Capsule Preovulation elavated progesterone was positively associated with the number of oocytes retrieved, but does not affect oocyte or embryo quality.
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Zhu, H., Liu, L., Yang, L. et al. The effect of progesterone level prior to oocyte retrieval on the numbers of oocytes retrieved and embryo quality in IVF treatment cycles: an analysis of 2,978 cycles. J Assist Reprod Genet 31, 1183–1187 (2014). https://doi.org/10.1007/s10815-014-0291-3
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DOI: https://doi.org/10.1007/s10815-014-0291-3