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Journal of Assisted Reproduction and Genetics

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01-07-2012 | ASSISTED REPRODUCTION TECHNOLOGIES

Progesterone levels on the hCG day and outcomes in vitro fertilization in women with polycystic ovary syndrome

Authors: Cuiying Peng, Zifen Guo, Xingyu Long, Guangxiu Lu

Published in: Journal of Assisted Reproduction and Genetics | Issue 7/2012

Abstract

Background

The purpose of this study was to determine the incidence of premature luteinization in patients with polycystic ovary syndrome and compared the main determinants of success in in-vitro fertilization in PCOS patients with and without premature luteinization.

Methods

Retrospective analysis of 180 PCOS women of Chinese Han origin with infertility who underwent controlled ovarian hyperstimulation (COH) with an exogenous gonadotropin/GnRH antagonist protocol. Hormone levels on the hCG day and IVF outcomes were assessed.

Results

The incidence of premature luteinization was 23.3 %. Compared with PCOS patients without premature luteinization, PCOS patients with premature luteinization(PL) had a higher number of oocytes retrieved (18.20 ± 6.6 vs 15.08 ± 7.3, p = 0.037) and a higher fertilization rate (72.9 ± 1.9 vs63.1 ± 2.3, p = 0.033), but clinical pregnancy rates were no statistical significance (53.3 vs 56.0, p = 0.836). Though the implantation rate was higher in no premature luteinization patients, but the difference was not statistically significant (37.7 vs 30.3, p = 0.115).

Conclusion

The PCOS patients with premature luteinization had a higher fertilization rate and high number of oocytes retrieved, and the similar implantation rate and clinical PRs as PCOS patients without premature luteinization.

Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC. PCOS according to the Rotterdam consensus criteria. Change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG-INT J Obstet Gy. 2006;113:1210–7.CrossRef

Papanikolaou EG, Kolibianakis EM, Pozzobon C, Tank P, Tournaye H, Bourgain C, Steirteghem A, Devroey P. Progesterone rise on the day of human chorionic gonadotropin administration impairs pregnancy outcome in day 3 single-embryo transfer, while has no effect on day 5 single blastocyst transfer. Fertil Steril. 2009;91:949–52.PubMedCrossRef

Bosch E, Valencia I, Escudero E, Crespo J, Simon C, Remohi J, Pellicer A. Premature luteinization during gonadotropin-releasing hormone antagonist cycles and its relationship with in vitro fertilization outcome. Fertil Steril. 2003;80:1444–9.PubMedCrossRef

Edelstein MC, Seltman HJ, Cox BJ, Robinson SM, Shaw RA, Muasher SJ. Progesterone levels on the day of human chorionic gonadotropin administration in cycles with gonadotropin-releasing hormone agonist suppression are not predictive of pregnancy outcome. Fertil Steril. 1990;54:853–7.PubMed

Martinez F, Coroleu B, Clua E, Tur R, Buxaderas R, Parera N, Barri PN, Balasch J. Serum progesterone concentrations on the day of HCG administration cannot predict pregnancy in assisted reproduction cycles. Reprod Biomed Online. 2004;8:183–90.PubMedCrossRef

Melo MA, Meseguer M, Garrido N, Bosch E, Pellicer A, Remohi J. The significance of premature luteinization in an oocyte-donation programme. Hum Reprod. 2006;21:1503–7.PubMedCrossRef

Fanchin R, de Ziegler D, Taieb J, Hazout A, Frydman R. Premature elevation of plasma progesterone alters pregnancy rates of in vitro fertilization and embryo transfer. Fertil Steril. 1993;59:1090–4.PubMed

Legro RS, Ary BA, Paulson RJ, Stanczyk FZ, Sauer MV. Premature luteinization as detected by elevated serum progesterone is associated with a higher pregnancy rate in donor oocyte in-vitro fertilization. Hum Reprod. 1993;8:1506–11.PubMed

Filicori M, Cognigni GE, Arnone R, Carbone F, Falbo A, Tabarelli C, Ciampaglia W, Casadio P, Spettoli D, Pecorari R. Role of different GnRH agonist regimens in pituitary suppression and the outcome of controlled ovarian hyperstimulation. Hum Reprod. 1996;11(Suppl3):123–32.PubMedCrossRef

10.

World Health Organization. WHO laboratory manual for the examination of human semen and sperm–cervical mucus interaction. 4th ed. Cambridge: Cambridge University Press; 1999.

11.

The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group, Fauser BCJM. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41–7.

12.

Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22:141–6.PubMedCrossRef

13.

Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States. A prospective study. J Clin Endocrinol Metab. 1998;83:3078–82.PubMedCrossRef

14.

Christian RC, Dumesic DA, Behrenbeck T, Oberg AL, Sheedy 2nd PF, Fitzpatrick LA. Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88:2562–8.PubMedCrossRef

15.

Glueck CJ, Morrison JA, Wang P. Insulin resistance, obesity, hypofibrinolysis, hyperandrogenism, and coronary heart disease risk factors in 25 pre-perimenarchal girls age <14or =14 years, 13 with precocious puberty, 23 with a first-degree relative with polycystic ovary syndrome. J Pediatr Endocrinol Metab. 2008;21:973–84.PubMedCrossRef

16.

Legro RS. Polycystic ovary syndrome and cardiovascular disease: a premature association? Endocr Rev. 2003;24:302–12.PubMedCrossRef

17.

Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome. a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84:165–9.PubMedCrossRef

18.

Ovalle F, Azziz R. Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertil Steril. 2002;77:1095–105.PubMedCrossRef

19.

Mehrabian F, Khani B, Kelishadi R, Ghanbari E. The prevalence of polycystic ovary syndrome in Iranian women based on different diagnostic criteria. Endokrynologia Polska/Polish Journal of Endocrinology. 2011;62:238–42.

20.

Elnashar AM. Progesterone rise on the day of HCG administration (premature luteinization) in IVF. An overdue update. J Assist Reprod Genet. 2010;27:149–55.PubMedCrossRef

21.

Bukulmez O, Rehman KS, Langley M, Carr BR, Nackley AC, Doody KM. Precycle administration of GnRH antagonist and microdose HCG decreases clinical pregnancy rates without affecting embryo quality and blastulation. Reprod Biomed Online. 2006;13:465–75.PubMedCrossRef

22.

Li R, Qiao J, Wang L, Zhen X, Lu Y. Serum progesterone concentration on day of HCG administration and IVF outcome. Reprod Biomed Online. 2008;16:627–31.PubMedCrossRef

23.

Yovel I, Yaron Y, Amit A, Peyser MR, David MP, Kogosowski A, Lessing JB. High progesterone levels adversely affect embryo quality and pregnancy rates in in vitro fertilization and oocyte donation programs. Fertil Steril. 1995;64:128–31.PubMed

24.

Hofmann GE, Bentzien F, Bergh PA, Garrisi GJ, Williams MC, Guzman I, Navot D. Premature luteinization in controlled ovarian hyperstimulation has no adverse effect on oocyte and embryo quality. Fertil Steril. 1993;60:675–9.PubMed

25.

Givens CR, Schriock ED, Dandekar PV, Martin MC. Elevated serum progesterone levels on the day of human chorionic gonadotropin administration do not predict outcome in assisted reproduction cycles. Fertil Steril. 1994;62:1011–7.PubMed

26.

Schoolcraft W, Sinton E, Schlenker T, Huynh D, Hamilton F, Meldrum DR. Lower pregnancy rate with premature luteinization during pituitary suppression with leuprolide acetate. Fertil Steril. 1991;55:563–6.PubMed

27.

Ubaldi F, Smitz J, Wisanto A, Joris H, Schiettecatte J, Derde MP, Borkham E, Steirteghem AV, Devroey P. Oocyte and embryo quality as well as pregnancy rate in intracytoplasmic sperm injection are not affected by high follicular phase serum progesterone. Hum Reprod. 1995;10:3091–6.PubMedCrossRef

Title: Progesterone levels on the hCG day and outcomes in vitro fertilization in women with polycystic ovary syndrome
Authors: Cuiying Peng
Zifen Guo
Xingyu Long
Guangxiu Lu
Publication date: 01-07-2012
Publisher: Springer US
Published in: Journal of Assisted Reproduction and Genetics / Issue 7/2012
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-012-9762-6

At a glance: The STEP trials

Springer Medicine

Progesterone levels on the hCG day and outcomes in vitro fertilization in women with polycystic ovary syndrome

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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