Prediction of pregnancy outcome by serum progesterone level after assisted reproductive technology

Abstract

OBJECTIVE: To determine the predictive value of serum progesterone level in patients with a positive β-hCG after controlled ovarian hyperstimulation (COH) followed by intrauterine insemination (IUI) or in vitro fertilization (IVF).DESIGN: Retrospective chart review.MATERIALS AND METHODS: Using the Practice Highway EIVF Query research tool, all cycles for patients beginning treatment between January 1, 2004 and December 31, 2007 were examined. Patients who became pregnant and had luteal progesterone measured were selected for analysis. Pregnancy outcomes were compared with progesterone levels, and the sensitivity and specificity of progesterone level to predict ongoing pregnancy were determined. For all statistical analyses, p<0.05 was considered significant.Table 1Prediction of Favorable Pregnancy Outcome by Quartile of Progesterone ValueQuartileProgesterone Range (ng/mL)N (%) OP+LBN (%) LossPPVNPV10 - 8.422 (27.5)58 (72.5)67.8%72.5%28.4 - 24.241 (46.6)47 (53.4)75.9%62.5%324.2 - 41.0154 (74.8)52 (25.2)84.6%42.0%441.0 - 38522 (84.6)4 (15.4)N/AN/AOP+LB = Ongoing Pregnancy + Live Birth; Loss = Ectopic, SAB, Biochemical; Positive and Negative Predictive Value (PPV & NPV) refer to the prediction of OP+LB by the upper limit of each quartile; A statistically significant difference (p<0.01) is found between the proportion of OP+LB in all quartiles except 3 vs. 4 (p=0.213). Open table in a new tab CONCLUSIONS: Progesterone level is directly correlated with favorable pregnancy outcome among patients undergoing ART. Discriminatory progesterone value may vary by mode of conception. Our study represents the largest group of infertile patients analyzed for the predictive value of luteal progesterone on pregnancy outcome. OBJECTIVE: To determine the predictive value of serum progesterone level in patients with a positive β-hCG after controlled ovarian hyperstimulation (COH) followed by intrauterine insemination (IUI) or in vitro fertilization (IVF). DESIGN: Retrospective chart review. MATERIALS AND METHODS: Using the Practice Highway EIVF Query research tool, all cycles for patients beginning treatment between January 1, 2004 and December 31, 2007 were examined. Patients who became pregnant and had luteal progesterone measured were selected for analysis. Pregnancy outcomes were compared with progesterone levels, and the sensitivity and specificity of progesterone level to predict ongoing pregnancy were determined. For all statistical analyses, p<0.05 was considered significant. OP+LB = Ongoing Pregnancy + Live Birth; Loss = Ectopic, SAB, Biochemical; Positive and Negative Predictive Value (PPV & NPV) refer to the prediction of OP+LB by the upper limit of each quartile; A statistically significant difference (p<0.01) is found between the proportion of OP+LB in all quartiles except 3 vs. 4 (p=0.213). CONCLUSIONS: Progesterone level is directly correlated with favorable pregnancy outcome among patients undergoing ART. Discriminatory progesterone value may vary by mode of conception. Our study represents the largest group of infertile patients analyzed for the predictive value of luteal progesterone on pregnancy outcome.