Abstract
Study Objective: To determine the relationship between testosterone and progesterone levels on day of HCG and IVF outcome. Design: Retrospective analysis. Setting: Weill Cornell Medical College- The Center for Reproductive Medicine and Infertility. Patients: Fifty consecutive patients who underwent IVF stimulation using Lupron or low dose Lupron (LDL) suppression protocols were included (25 Lupron, 25 LDL). Patients older than 35 were excluded. Intervention: Frozen serum samples from day 2/3 of the cycle, as well as day of HCG were pulled and re-analyzed for testosterone and progesterone levels . Statistical analysis was performed using the student t test, Mann-Whitney U test and chi-square test when appropriate. P<0.05 was considered statistically significant. Measurements and Main Results: There was no significant difference between the groups in age, BMI, days of stimulation, random day 3 FSH, LH levels, Day 2/3 Progesterone and Testosterone levels and the total dose of gonadotropins. Those undergoing stimulation with Lupron had a higher antral follicle count (13.5 vs. 11.6 p=0.02). We identified a trend towards a higher testosterone levels on day of HCG in the LDL protocol when compared with the Lupron protocol (56.7 29.8 Vs 45.0 26.3 P=0.12). No difference was seen in Progesterone levels on day of HCG (0.640.26 vs. 0.74 0.38 p=0.04). We found no difference between the 2 protocols in terms of number of oocytes retrieved, number of mature oocytes, fertilization rate, implantation rate and pregnancy rates.Tabled 1LupronLDLP valueAge31.332.2NSBMI23.122.5NSAFC13.511.60.02Random FSH MIU/ML7.07.6NSRandom LH MIU/ML4.94.5NSTotal Gonadotropins IU1503.61834.4NSDays of Stimulation8.89NSTestosterone on HCG day (ng/dl)45 ± 26.356.7 ± 29.80.15Progesterone on day of HCG (ng/ml)0.64 ± 0.260.74 ± 0.38NS Open table in a new tab Conclusion: There was no significant difference between the Lupron and LDL protocol in terms of IVF outcomes and testosterone and progesterone levels prior to and on the day of HCG injection. There may be a wide range of testosterone levels that can be tolerated without a detrimental effect on IVF outcomes.
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