Abstract

BackgroundThis study aimed at determining the predictive value of human chorionic gonadotropin and progesterone levels on pregnancy outcomes in patients receiving in vitro fertilization due to fallopian tube associated infertility.MethodsWe retrospectively analyzed the clinical data of 854 cycles due to fallopian tube associated infertility in vitro fertilization fresh embryo transfer. The clinical data had been collected from January 2010 to December 2018 and was divided into 7 groups depending on the progesterone level on human chorionic gonadotropin administration day. Live birth rates and observation trends were calculated. The receiver operating characteristic curve was established to determine the optimal cutoff value for progesterone, which was used to further divide the data into 3 groups; Group 1 (progesterone ≦ 1.0 ng/ml), Group 2 (1.0 ng/ml ≤ progesterone ≤ 1.25 ng/ml), and Group 3 (progesterone ≥ 1.25 ng/ml). We then compared the ovulation results and clinical outcomes among the 3 groups.ResultsThere were no significant differences in age, infertility years, gonadotropin dosage, gonadotropin days, Luteinizing hormone level on human chorionic gonadotropin day, 2 pronuclear fertilization rates, clinical pregnancy rates, live birth rates, full-term birth rate, and preterm birth rates among the three groups. However body mass index (p = 0.001), basal luteinizing hormone (p = 0.034), estrogen peak (p < 0.001), number of oocytes obtained (P < 0.001) were significantly different.ConclusionsProgesterone level on human chorionic gonadotropin day does not affect the clinical pregnancy rate and live birth rates after in vitro fertilization. However, progesterone levels between 1.0 and 1.25 ng/ml may lead to good clinical pregnancy outcomes.

Highlights

  • This study aimed at determining the predictive value of human chorionic gonadotropin and progesterone levels on pregnancy outcomes in patients receiving in vitro fertilization due to fallopian tube associated infertility

  • A different study reported that low P levels (≤ 0.5 ng/ml) on the day of human chorionic gonadotropin (HCG) administration are associated with low live birth rates(LBR)[3]

  • Multiple studies have reported that in gonadotropin-releasing hormone (GnRH) downregulated cycles, premature increase in P levels on the day of HCG administration negatively correlates with in vitro fertilization (IVF) outcomes

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Summary

Introduction

This study aimed at determining the predictive value of human chorionic gonadotropin and progesterone levels on pregnancy outcomes in patients receiving in vitro fertilization due to fallopian tube associated infertility. A recent study revealed that elevated P levels on the day of human chorionic gonadotropin (HCG) administration negatively affects live birth rates and are correlated with high rates of miscarriage. Multiple studies have reported that in gonadotropin-releasing hormone (GnRH) downregulated cycles, premature increase in P levels on the day of HCG administration negatively correlates with IVF outcomes. Different P threshold values were used in different studies These factors affect the reliability of the results and the capacity of P levels to be used as predictors of pregnancy outcomes. All participants in the studies were normal ovarian responders and the embryos were transferred on the third day

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