Impact of Progesterone on Inhibins during Controlled Ovarian Stimulation

Abstract

Background: To explore the impact of progesterone on inhibins during controlled ovarian stimulation in women with normal ovarian reserve and to compare cycle characteristics and pregnancy outcomes in subsequently frozen-thawed embryo transfer (FET) cycles. Methods: A total of 93 patients were randomly divided into two groups, study group (human menopausal gonadotropin [hMG] + medroxyprogesterone acetate [MPA]) and control group (short protocol). Serum hormones were detected on day 3 before ovarian and day 10-12, the trigger day, and the day after trigger (approximately 10 h after trigger). Viable embryos were cryopreserved for later transfer in both protocols. Results: In the study group, inhibins signifcantly increased during ovarian stimulation, and the average inhibins level on the trigger day was signifcantly higher than the basal levels. Inhibin A level increased significantly to 2046.7 ± 1280.5 ng/L after trigger 10 h. Serum inhibin B level slightly decreased at the time of trigger 10 h later compared with the trigger time but did not reach a significant difference. The number of oocytes retrieved in study group was similar to that in control (10.5 ± 4.5 vs. 9.0 ± 5.2, P > 0.05). No statistically significant differences were found in the clinical pregnancy rate (47.4% vs. 52.2%, P > 0.05), implantation rate (36.5% vs. 36%), and live birth rate (43.4% vs. 39.1%, P > 0.05) between the two groups. Conclusions: The high level of progesterone did not affect the secretion in granulosa cells during the controlled ovarian stimulation. Therefore, sufficient oocytes/embryos can be obtained by hMG and MPA co-treatment in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatments, with optimal pregnancy outcomes in FET cycles.