Should progesterone on the human chorionic gonadotropin day still be measured?

Abstract

Objective: To evaluate in our setting whether there is currently a level of P on the hCG day (P-hCG) predictive of no pregnancy.

Design: Observational study of prospectively collected data of the P-hCG levels of stimulated IVF cycles.

Setting: In vitro fertilization unit.

Patient(s): All cycles of IVF/intracytoplasmic sperm injection with fresh embryo transfer performed between January 2009 and March 2014.

Intervention(s): None.

Main outcome measure(s): Pregnancy rate.

Result(s): Clinical pregnancy rate per ET was 38.7% and live birth rate was 29.1%. The P-hCG concentration was positively correlated to E2 on the hCG day, and the number of oocytes was negatively correlated to age. Progesterone on hCG day was higher among agonist- compared with antagonist-treated patients (mean ± SD: 1.13 ± 0.69 ng/mL vs. 0.97 ± 0.50 ng/mL) and among recombinant FSH compared with recombinant FSH + hMG stimulation (mean ± SD: 1.11 ± 0.58 ng/mL vs. 0.94 ± 0.50 ng/mL). Pregnancy rate was positively associated with the number of oocytes. There was no correlation between P-hCG value and pregnancy rate, overall or according to the type of treatment.

Conclusion(s): In our setting there is no P-hCG value differentiating a good from a poor cycle success rate.

Clinical trial registration number: NCT02323347.

Keywords: Clinical outcomes; ovarian stimulation; pregnancy rate; progesterone levels.