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Archives of Gynecology and Obstetrics

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01-04-2010 | Reproductive Medicine

Premature progesterone elevation impairs implantation and live birth rates in GnRH-agonist IVF/ICSI cycles

Authors: Esra Bulgan Kiliçdag, Bulent Haydardedeoglu, Tayfun Cok, Servet Ozden Hacivelioglu, Tayfun Bagis

Published in: Archives of Gynecology and Obstetrics | Issue 4/2010

Abstract

Introduction

Our aim was to investigate the clinical significance of premature elevated progesterone levels in women with good ovarian response treated with long gonadotropin-releasing hormone agonist (GnRH-a) cycles and IVF. Premature elevated progesterone levels refer to a rise in serum progesterone levels on the day of human chorionic gonadotrophin (hCG) administration for final oocyte maturation above a threshold level, which is usually arbitrarily defined.

Materials and methods

This is a retrospective case study, which consists of 1,045 treatment cycles in women with low P/E2 [progesterone (ng/mL) × 1,000/estradiol (pg/mL)] on the day of hCG. Elevated P levels on the day of hCG administration were defined as >1.1 ng/mL. The data of the control group (≤1.1 ng/mL, n = 900 patients) were compared with those of the high P group (>1.1 ng/mL, n = 145).

Results

Compared with the control group, those in the high progesterone group had higher levels of estradiol on the day of hCG (3,143 vs. 2,382 pg/ml) (p: 0.000) and higher numbers of MII oocytes (14.0 and 12.9) (p: 0.001). The total number of embryos and the number of good-quality embryos transferred did not differ significantly between the groups. Implantation rate (18.1 vs. 24.4%) (p: 0.008), and live birth rate (27.6 vs. 40%) (p: 0.004), were significantly lower in patients with high progesterone levels. OR and 95% CI were 0.57 (0.39–0.84) for the live birth rate.

Conclusion

In women stimulated with GnRHa and hMG/FSH for IVF, elevated serum progesterone levels on the day of hCG administration were associated with diminished implantation rates and live birth rates regardless of ovarian reserve.

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Title: Premature progesterone elevation impairs implantation and live birth rates in GnRH-agonist IVF/ICSI cycles
Authors: Esra Bulgan Kiliçdag
Bulent Haydardedeoglu
Tayfun Cok
Servet Ozden Hacivelioglu
Tayfun Bagis
Publication date: 01-04-2010
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 4/2010
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-009-1248-0

2024 ASCO Annual Meeting

Springer Medicine

Premature progesterone elevation impairs implantation and live birth rates in GnRH-agonist IVF/ICSI cycles

Abstract

Introduction

Materials and methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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