Abstract
Objective
To ascertain the association between basal progesterone (P) levels and the occurrence
of preovulatory progesterone rise (PPR) and clinical pregnancy rates (CPRs) in ICSI
cycles with GnRH antagonists.
Study design
Serum P levels of 464 patients were measured on day 2 and day of hCG of cycles. Cycles
with basal P levels > 1.6 ng/mL were cancelled. All embryos were cryopreserved in cycles with P levels ≥ 2 ng/mL on the day of hCG. The primary outcome measures were the incidence of PPR (P > 1.5 ng/mL) and CPR with regard to basal P.
Results
Basal P levels were significantly higher in cycles with PPR than in those without
PPR (0.63 ± 0.31 vs. 0.48 ± 0.28 ng/mL). Area under the curve for basal P according to ROC analysis to discriminate
between elevated and normal P levels on the day of hCG was 0.65 (0.58–0.71 95% CI,
p < 0.01). The cut-off value for basal P levels that best discriminates between cycles
with and without PPR was 0.65 ng/mL. Cycles with basal P levels above 0.65 ng/mL had a significantly higher incidence of PPR (30.9% vs. 13.5%) but similar clinical
and cumulative pregnancy rates (38.8% vs. 31.1% and 41.7% vs. 32.6%, respectively)
in comparison to cycles with basal P levels below 0.65 ng/mL. In multivariate regression analysis, basal P levels, LH level on the first
day of antagonist administration, and estradiol levels on the day of hCG trigger were
the variables that predicted PPR.
Conclusion
Basal P levels were associated with increased incidence of PPR but not with CPR.
Keywords
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Article info
Publication history
Published online: June 29, 2017
Accepted:
June 28,
2017
Received in revised form:
June 20,
2017
Received:
June 18,
2016
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
