Progesterone elevation does not compromise pregnancy rates in high responders: a pooled analysis of in vitro fertilization patients treated with recombinant follicle-stimulating hormone/gonadotropin-releasing hormone antagonist in six trials.
Title | Progesterone elevation does not compromise pregnancy rates in high responders: a pooled analysis of in vitro fertilization patients treated with recombinant follicle-stimulating hormone/gonadotropin-releasing hormone antagonist in six trials. |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | Griesinger, G., Mannaerts B., Andersen C. Yding, Witjes H., Kolibianakis E. M., & Gordon K. |
Journal | Fertil Steril |
Volume | 100 |
Issue | 6 |
Pagination | 1622-8.e1-3 |
Date Published | 2013 Dec |
ISSN | 1556-5653 |
Keywords | Adolescent, Adult, Biological Markers, Clinical Trials as Topic, Female, Fertilization in Vitro, Follicle Stimulating Hormone, Follicular Phase, Gonadotropin-Releasing Hormone, Humans, Infertility, Female, Internationality, Ovulation Induction, Pregnancy, Pregnancy Outcome, Prevalence, Progesterone, Prognosis, Treatment Outcome, Young Adult |
Abstract | OBJECTIVE: To compare the impact of elevated P during the late follicular phase on the chance of pregnancy in low, normal, and high responders.DESIGN: Retrospective combined analysis from six clinical trials.SETTING: IVF centers.PATIENT(S): Women up to 39 years of age with a regular menstrual cycle and an indication for ovarian stimulation before IVF/intracytoplasmic sperm injection.INTERVENTION(S): Ovarian stimulation with recombinant (r) FSH in a GnRH antagonist protocol.MAIN OUTCOME MEASURE(S): Ongoing pregnancy rates (OPRs) assessed with the use of univariate and multivariate analyses according to serum P levels ≤ 1.5 ng/mL versus >1.5 ng/mL on the day of hCG administration and compared among low (1-5 oocytes), normal (6-18 oocytes), and high (>18 oocytes) responders.RESULT(S): A total of 157/1,866 women (8.4%; 95% confidence interval [CI] 7.2%-9.8%) had elevated P. Incidence of elevated P increased from 4.5% in low responders to 19.0% in high responders. Overall, OPRs were significantly lower in women with elevated P. Per started cycle, the >1.5 to ≤ 1.5 ng/mL adjusted odds ratio was 0.55 (95% CI 0.37-0.81). OPRs were not impaired in high responders with P elevation and were significantly higher compared with normal responders with P elevation.CONCLUSION(S): The incidence of elevated P increases with ovarian response, and elevated P at a threshold of 1.5 ng/mL is independently associated with a decreased chance of pregnancy in low to normal responders, but not in high responders, when using an rFSH/GnRH antagonist protocol. |
DOI | 10.1016/j.fertnstert.2013.08.045 |
Alternate Journal | Fertil. Steril. |
PubMed ID | 24083873 |