Does subtle progesterone rise on the day of HCG affect pregnancy rate in long agonist ICSI cycles?

Abstract

P4 values > or =1 ng/mL on day of hCG are common in long agonist ICSI cycles particularly with high response. Within the P4 values encountered in this study, implantation and pregnancy rates are not adversely affected.

Premature progesterone rise negatively correlated with live birth rate in IVF cycles with GnRH agonist: an analysis of 2,566 cycles

“…Actually, in most studies, the methods to determine the cutoff value (varying from 0.9 to 2.0 ng/mL) defining PPR were arbitrarily chosen (6,8,12), which undoubtedly undermines the reliability of any conclusion. In some other studies, receiver operating characteristic curve analysis was used to determine the cutoff value (5,11). Nevertheless, that is not a proper method, because our data showed that the relationship between P levels and live birth rates is not linear, which is consistent with Bosch et al's report (14).…”

“…limited number of patients recruited or a relatively low threshold used to define PPR (5,11,21). As far as we know, the present study included the largest number of patients (n ¼ 1,719) treated with long protocol, strengthening the reliability of our conclusion.…”

“…Some showed that PPR was associated with decreased pregnancy rate (6)(7)(8), some presented data against the negative effect of PPR (9)(10)(11), and some even reported positive correlation between PPR and pregnancy rate (12). In 2007, Venetis et al (13) published the first systematic review and meta-analysis, including 12 studies, and concluded that PPR was not associated with the probability of pregnancy.…”

Serum progesterone level effects on the outcome of in vitro fertilization in patients with different ovarian response: an analysis of more than 10,000 cycles

“…However, the value of that metaanalysis was thought to be limited because it defined an imprecise threshold for a detrimental serum P level, with most of the studies failing to demonstrate an association arbitrarily using a low threshold level of 0.9 ng/mL (28). Another point of difference between these studies is the variation in the statistical methods used to assess the specific cutoff value of circulating P:A some smaller studies used receiver operating characteristic (ROC) curve analysis to assess the impact of P levels on pregnancy outcome, although the area under the ROC curve may not be the most suitable test for this analysis, because the relationship between serum P levels and pregnancy outcomes is not linear (27,29). The variation across these studies emphasizes the importance of using appropriate methodologic approaches (30).…”

Does elevated serum progesterone on the day of human chorionic gonadotropin administration decrease live birth rates?

“…Numerous studies have suggested that progesterone elevation is associated with decreased pregnancy rates, 5,6,8–12 while others have presented contradictory data. 13–18 Doldi et al 19 even reported a positive association between elevated progesterone and pregnancy in patients with polycystic ovary syndrome. An additional issue is the definition of normal and elevated progesterone during COH, as cut-off values for elevated levels have ranged from 0.4 to 3.0 ng/mL.…”