Journal of Clinical Endocrinology & Metabolism, Vol 73, 797-803, Copyright © 1991 by Endocrine Society

ARTICLES

Serum progesterone levels predict success of in vitro fertilization/embryo transfer in patients stimulated with leuprolide acetate and human menopausal gonadotropins

KM Silverberg, WN Burns, DL Olive, RM Riehl and RS Schenken
Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio 78284-7836.

Serum progesterone (P4) levels greater than 2.86 nmol/L (0.9 ng/mL) on the day of hCG administration are reportedly associated with decreased pregnancy rates in in vitro fertilization/embryo transfer (IVF/ET) cycles. To further assess this phenomenon we measured serial serum P4, LH, and estradiol levels in 115 consecutive patients undergoing stimulation for IVF/ET with midluteal leuprolide acetate and human menopausal gonadotropins. IVF/ET cycle outcome was retrospectively correlated with P4 levels on the day of hCG administration. Two critical breakpoints were identified, 1.27 nmol/L (0.4 ng/mL) and 286 nmol/L (0.9 ng/mL). Clinical pregnancies occurred in 9 of 18 patients in group I (P4, less than 1.27 nmol/L) compared to 11 of 81 patients in group II (1.27 less than P4 less than 2.86 nmol/L; P = 0.001) and 0 of 14 patients in group III (P4, less than or equal to 2.86 nmol/L) (P = 0.001). Eleven patients in group III had cryopreservation of embryos during that cycle. Six subsequently underwent frozen embryo transfer, and clinical pregnancies occurred in 2, both of whom have delivered. These findings demonstrate that even modest increases in serum P4 levels (greater than 1.27 nmol/L) are associated with reduced pregnancy rates in IVF/ET cycles. In addition, it appears that the mechanism may not exclusively involve poor oocyte quality.

This article has been cited by other articles:

				C.A. Venetis, E.M. Kolibianakis, E. Papanikolaou, J. Bontis, P. Devroey, and B.C. Tarlatzis Is progesterone elevation on the day of human chorionic gonadotrophin administration associated with the probability of pregnancy in in vitro fertilization? A systematic review and meta-analysis Hum. Reprod. Update, July 1, 2007; 13(4): 343 - 355. [Abstract] [Full Text] [PDF]

				M.A.B. Melo, M. Meseguer, N. Garrido, E. Bosch, A. Pellicer, and J. Remohi The significance of premature luteinization in an oocyte-donation programme Hum. Reprod., June 1, 2006; 21(6): 1503 - 1507. [Abstract] [Full Text] [PDF]

				M. Filicori, G.E. Cognigni, P. Pocognoli, C. Tabarelli, D. Spettoli, S. Taraborrelli, and W. Ciampaglia Modulation of folliculogenesis and steroidogenesis in women by graded menotrophin administration Hum. Reprod., August 1, 2002; 17(8): 2009 - 2015. [Abstract] [Full Text] [PDF]

				F. Martinez, P.N. Barri, B. Coroleu, R. Tur, T. Sorsa-Leslie, W. J. Harris, N. P. Groome, P. G. Knight, and P. A. Fowler Women with poor response to IVF have lowered circulating gonadotrophin surge-attenuating factor (GnSAF) bioactivity during spontaneous and stimulated cycles Hum. Reprod., March 1, 2002; 17(3): 634 - 640. [Abstract] [Full Text] [PDF]

				F.P. Hohmann, J.S.E. Laven, F.H. de Jong, M.J.C. Eijkemans, and B.C.J.M. Fauser Low-dose exogenous FSH initiated during the early, mid or late follicular phase can induce multiple dominant follicle development Hum. Reprod., May 1, 2001; 16(5): 846 - 854. [Abstract] [Full Text] [PDF]

				C. A. Krusche, A. Herrler, I. Classen-Linke, C. Hegele-Hartung, U. von Rango, and H. M. Beier Modulation of endometrial transformation in gonadotrophin-stimulated and unstimulated pseudo-pregnant rabbits: studies with the progesterone receptor antagonist, onapristone Mol. Hum. Reprod., August 1, 2000; 6(8): 726 - 734. [Abstract] [Full Text] [PDF]

				S. Yamada, H. Fujiwara, T. Honda, T. Higuchi, T. Nakayama, T. Inoue, M. Maeda, and S. Fujii Human granulosa cells express integrin {alpha}2 and collagen type IV: possible involvement of collagen type IV in granulosa cell luteinization Mol. Hum. Reprod., July 1, 1999; 5(7): 607 - 617. [Abstract] [Full Text] [PDF]

				N. Doldi, E. Marsiglio, A. Destefani, A. Gessi, G. Merati, and A. Ferrari Elevated serum progesterone on the day of HCG administration in IVF is associated with a higher pregnancy rate in polycystic ovary syndrome Hum. Reprod., March 1, 1999; 14(3): 601 - 605. [Abstract] [Full Text] [PDF]

				A. Levesque, M. Letellier, P. W. Dillon, and A. Grant Analytical performance of Bayer Immuno 1TM estradiol and progesterone assays Clin. Chem., September 1, 1997; 43(9): 1601 - 1609. [Abstract] [Full Text] [PDF]

				H. Fujiwara, T. Honda, M. Ueda, K. Nakamura, S. Yamada, M. Maeda, and T. Mori Laminin Suppresses Progesterone Production by Human Luteinizing Granulosa Cells via Interaction with Integrin {alpha}6{beta}1 J. Clin. Endocrinol. Metab., July 1, 1997; 82(7): 2122 - 2128. [Abstract] [Full Text] [PDF]