Abstract
ObjectiveTo analyze progesterone and prolactin plasma levels nine days after oocyte retrieval and evaluate their correlation with pregnancy rates in in vitro fertilization cycles. To achieve pregnancy, several factors are analyzed before and during the in vitro fertilization cycle. Progesterone supplementation for adequate luteal phase support is indicated despite the presence of multiple corpus luteum in IVF stimulation cycles because of blockage caused by hypothalamic agonists and antagonists. The dosage of progesterone and prolactin on day 09 after follicular retrieval could function as a predictive marker of success in fertility treatments.MethodsA retrospective study was performed using data from 238 patients submitted to intracytoplasmic sperm injection (ICSI) at a private infertility clinic from January 2013 to December 2015. Hormonal measurements were performed on day 09 after follicular uptake. The data was compared to assess the correlation between prolactin and progesterone dosages and pregnancy rates. ResultsThe ICSI pregnancy rate was 40.8% (n=238). No statistically significant difference was observed when correlating the success of the procedure with the prolactin dosage (p=0.71). However, progesterone showed a significant difference (p=0.021). The cutoff point, indicated by the ROC curve fit according to which gestation would be identified, is 25.95ng/ml of progesterone. The sensitivity of this point is 61.9% and the specificity is 57.4%.ConclusionProgesterone dosage may be one of the indicators of gestation on day 09 after follicular uptake. Such data can help physicians to monitoring and provides suitable early gestational care. More studies are needed to corroborate the data found.
Highlights
Several studies have attempted to determine cut-off points with laboratory tests that can predict the success of fertilization cycles before serum analysis of human chorionic gonadotropin (hCG)
No statistically significant difference was observed when correlating the success of the procedure with the prolactin dosage (p=0.71)
These analyses can be used to adjust the doses of progesterone administered during the luteal phase, because the prediction of pregnancy success is important for both couples and professionals working whit in vitro fertilization cycles (IVF) (Ioannidis et al, 2005)
Summary
Several studies have attempted to determine cut-off points with laboratory tests that can predict the success of fertilization cycles before serum analysis of hCG. These analyses can be used to adjust the doses of progesterone administered during the luteal phase, because the prediction of pregnancy success is important for both couples and professionals working whit in vitro fertilization cycles (IVF) (Ioannidis et al, 2005). Healthy embryos, adequate endometrium and a functional corpus luteum are required to maintain this receptive endometrium. The maintenance of this corpus luteum depends on normal LH pulses every 4 to 6 hours and adequate concentrations of prolactin, since this seems to increase progesterone synthesis (Medeiros, 2014)
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