Over-cooked eggs, really? Premature luteinization affects the endometrium, not the egg

Abstract

To determine if P4 values on day of trigger affect certain cycle outcome parameters as well as pregnancy outcomes in the subsequent first frozen embryo transfer cycle. Retrospective analysis. 238 patients undergoing ovarian stimulation/pre-gestational screening/freeze all protocols at our center during the time period of 2013-2014 were included. Excluded patients were those whose cycles were cancelled. Once patients were identified as eligible for this study, frozen serum from the day of trigger was identified and analyzed using the Siemens Immulite 2000. Number of eggs retrieved, number of available embryos for biopsy, and percent of resultant euploid embryos were analyzed. The first frozen embryo transfer cycle was linked to the initial egg retrieval and outcomes including pregnancy rates and live birth/ongoing pregnancy rates were calculated and analyzed. A discriminatory P4 value of 1.5 ng/ml was set to distinguish groups A and B. T-tests and chi-squared tests were used for statistical analysis. Group A had an average trigger P4 value of 0.87 +/- 0.3 and group B had an average trigger P4 of 2.1 +/- 0.8. Table 1 shows the baseline characteristics of both group A and group B. The only significant difference between the two groups was total gonadotropin dosage (IU) with a p-value of 0.02 and estradiol (pg/ml) at trigger, also with a p-value of 0.02 (Table 1). Number of eggs retrieved, number of embryos biopsied, percent euploid and non-diagnosis embryos were all non-significant. Chi-square analysis was used to compare pregnancy rates between the two groups after the first frozen embryo transfer cycle. Group A had a pregnancy rate of 72% and Group B had a pregnancy rate of 66.7%, which was not significant. Ongoing pregnancy/live birth rates were 65.6% in group A and 66.67% in group B, also not significant (Table 1). P4 values on day of trigger do not affect number of eggs retrieved and number of chromosomally normal embryos available for transfer in a subsequent embryo transfer cycle. Elevated P4 values (>1.5 ng/ml) also do not affect pregnancy rates or live birth/ongoing pregnancy rates in the first subsequent frozen embryo transfer cycle.Tabled 1Comparison of groups related to cycle outcomes.Group A (P4)Group B (P4>1.5 ng/ml)p-value (*t-test, **chi-sqaure)Age (years)38.4 +/- 4.138.4 +/-3.70.89*Total Gonadotropins (IU)3795.34 +/- 15394395.2 +/- 1521.70.02*Estradiol at trigger (pg/ml)2483.8 +/- 1048.13034.2 +/- 1495.30.02*# Eggs retrieved14.5 +/- 7.915.7 +/-7.00.34*# Embryos biopsied5.0 +/- 3.975.2 +/-3.50.73*% Euploid Embryos32.7 +/-31.529.4 +/- 29.20.51*% No diagnosis embryos10.4 +/- 26.411.2 +/-26.40.86*% No normal embryos32.1 (26-38.9)25.5 (15.1-39.6)0.19**Clinical pregnancy rate (%)72 (62.1-79.5)66.7 (47.7-81.5)0.31**Implantation rate (%)59.8 (50.6-68.4)66.7 (47.7-81.5)0.43**Ongoing/Live birth rate (%)65.6 (56-74.2)66.7 (47.7-81.5)0.46** Open table in a new tab