Serum progesterone elevation adversely affects cumulative live birth rate in different ovarian responders during in vitro fertilization and embryo transfer: a large retrospective study

PLoS One. 2014 Jun 13;9(6):e100011. doi: 10.1371/journal.pone.0100011. eCollection 2014.

Abstract

In order to explore the relationship between serum progesterone (P) level on the day of human chorionic gonadotrophin (HCG) administration and cumulative live birth rate in patients with different ovarian response during in vitro fertilization (IVF), we carried out this retrospective cohort study including a total of 4,651 patients undergoing their first IVF cycles from January 2011 to December 2012. All patients with a final live birth outcome (4,332 patients) were divided into three groups according to ovarian response: poor ovarian responder (≤5 oocytes, 785 patients), intermediate ovarian responder (6-19 oocytes, 3065 patients) and high ovarian responder (≥20 oocytes, 482 patients). The thresholds for serum P elevation were 1.60 ng/ml, 2.24 ng/ml, and 2.50 ng/ml for poor, intermediate, and high ovarian responders, respectively. Cumulative live birth rate per oocyte retrieval cycle was calculated in each group. The relationship between serum P level and cumulative live birth rate was evaluated by both univariate and multivariate logistic regression analysis. Cumulative live birth rate per oocyte retrieval cycle was inversely associated with serum P level in patients with different ovarian response. For all responders, patients with elevated P level had significantly higher number of oocytes retrieved, but lower high quality embryo rate, and lower cumulative live birth rate compared with patients with normal serum P level. In addition, serum P level adversely affected cumulative live birth rate by both univariate and multivariate logistic regression analysis, independent of ovarian response. Serum P elevation on the day of HCG administration adversely affects cumulative live birth rate per oocyte retrieval cycle in patients with different ovarian response.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chorionic Gonadotropin / administration & dosage
  • Embryo Transfer* / statistics & numerical data
  • Female
  • Fertilization in Vitro* / statistics & numerical data
  • Humans
  • Infant, Newborn
  • Infertility / blood
  • Infertility / epidemiology
  • Infertility / therapy*
  • Male
  • Oocyte Retrieval / statistics & numerical data
  • Ovarian Reserve / physiology
  • Ovulation Induction* / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy Rate*
  • Progesterone / blood*
  • Retrospective Studies

Substances

  • Chorionic Gonadotropin
  • Progesterone

Grants and funding

This work was supported by the National Natural Science Foundation of China (Grant NO. 31271605 and U1304315) and Youth Foundation of The First Affiliated Hospital of Zhengzhou University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.