Impact of Serum Progesterone Levels in GnRH Antagonist Assisted Reproduction Cycles on Pregnancy Outcomes: A Prospective Cohort Study ()
Affiliation(s)
1Obstetrics and Gynecology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
2Armed Forces Hospital North-Western Region, Tabuk, Saudi Arabia.
3Obstetrics and Gynecology Department, King Faisal Military Hospital, Khamis Mushait, Saudi Arabia.
4Obstetrics and Gynecology Department, Zagazig University, Zagazig, Egypt.
ABSTRACT
Background: With
controlled ovarian hyperstimulation (COH) with gonadotrophin releasing hormone
(GnRH) antagonists, sometimes it is associated with incomplete luteolysis
leading to elevated serum progesterone in early follicular phase. Persistence
of this elevation might reduce the chance for clinical pregnancy. Objective: To assess the effect of elevated early and late follicular progesterone
(P) levels during gonadotrophins releasing hormone (GnRH) antagonist cycles on
pregnancy outcome. Design: Prospective single center study. Setting: North-western
Military hospital, Kingdom of Saudi Arabia. Patients: 302 in vitro fertilization/intra-cytoplasmic
sperm injection (IVF-ICSI) patients. Intervention(s): Recombinant follicle stimulating hormone (r-FSH),
(150 - 300 IU) started daily from cycle day 2; GnRH antagonist treatment started
on day 6 of the cycle. The serum progesterone (P) measured twice on cycle day 2
and human chorionic gonadotrophin (hCG) day. Main Outcome Measures: Clinical pregnancy and live birth rates per started
cycle. Results: The incidence of elevated serum P on day 2 was (5.3%) and on hCG day was
(17.5%), statistically significant differences in
clinical pregnancy rate (32.3% versus 13.0%) and in
live birth rate (23.4% versus 11.1%) were present between the normal and high serum progesterone groups on hCG
day, but these differences were not statistically significant in the groups of
elevated basal progesterone. Conclusion: Follicular phase progesterone
rise either on day 2 or the day of hCG trigger was associated with lower
clinical pregnancy and live birth rates. This impact was more prominent with
trigger day elevation.
Share and Cite:
Abdelaziz, A. and Atia, H. (2019) Impact of Serum Progesterone Levels in GnRH Antagonist Assisted Reproduction Cycles on Pregnancy Outcomes: A Prospective Cohort Study.
Open Journal of Obstetrics and Gynecology,
9, 42-53. doi:
10.4236/ojog.2019.91005.
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