Progesterone/estradiol ratio

Abstract

ObjectiveIt has been suggested that a progesterone/estradiol ratio (P/E2) ≥ 1.0 on the day of human chorionic gonadotropin (hCG) administration indicates premature luteinization and might be associated with an adverse pregnancy; however, a lower limit of this ratio has not been determined. We aimed to identify a lower limit of P/E2 that correlates significantly with an increase in adverse pregnancies in patients undergoing a prolonged in vitro fertilization/intracytoplasmic sperm injection therapy. Materials and MethodsThis retrospective analysis involved 7451 patients who received the first cycle of in vitro fertilization/intracytoplasmic sperm injection therapy treatment at the Reproductive and Genetic Hospital of Citic–Xiangya between January 2008 and April 2012. Patients were stratified into six groups according to their P/E2 on the day of hCG administration. Primary pregnancy outcomes, rates of implantation, clinical pregnancy, ongoing pregnancies, spontaneous abortions, and live births were recorded. The association between P/E2 on the day of hCG administration and primary pregnancy outcomes was assessed using logistic regression analysis. ResultsThe rates of implantation (23.85–33.44%), clinical pregnancy (47.42–67.12%), ongoing pregnancy (40.83–61.48%), and live birth (34.40–57.65%) were significantly decreased in patients with a P/E2 < 0.25. These indicators were significantly associated with P/E2, but no significant correlation was observed between P/E2 and early spontaneous abortion rate. ConclusionP/E2 < 0.25 on the day of hCG administration was associated with adverse pregnancy outcomes in extended treatments of gonadotropin-releasing hormone agonist IVF/ICSI.