Effect of High Progesterone Level on Day of Human Chrionic Gonadotropin Triggering on Pregnancy Rate in Frozen Embryo Transfer

Abstract

Background: The endometrial morphology and receptivity, the embryo implantation procedure and the success rate of In vitro fertilization (IVF) are all significantly influenced by progesterone. The increased progesterone adversely affected the endometrial environment of fresh cycles, reducing the chance of pregnancy. However, the embryo quality is equally as crucial to the embryo-endometrial cross-dialog as endometrial receptivity, based on the rate of pregnancy in frozen cycles. Objective: The aim of the current study was to determine how Day of human chorionic gonadotropin (HCG) was impacted by early progesterone rise. Patients and methods: A retrospective cohort research was conducted in the Obstetrics and Gynaecology Department of the Zagazig University Hospital. The study included records of all cases fulfilling the next inclusion criteria: Women with any type of subfertility who underwent frozen embryo transfer, Age less than 40 years old, gonadotropin-releasing hormone (GnRH) antagonist stimulation protocol in fresh Intracytoplasmic Sperm Injection (ICSI) cycle, Basal serum follicle stimulating hormone (FSH) concentration less than 15 mIU/mL. Over 5 years, 200 records were included as a comprehensive sample undergoing ICSI and subsequent frozen embryo. Results: Using a threshold value for serum progesterone previously described of 1.5 ng/ml, 142 from 200 (71%) frozen embryo transfers that involved the transfer of embryos from low progesterone level ICSI cycles, and 58 from 200 (29%) frozen embryo transfers in which embryos from elevated progesterone level. The evolution of pregnancy outcomes following ICSI cycles demonstrated that there was no discernible difference between the groups with higher blood levels. Conclusion: Elevated progesterone levels on the day of HCG do not negatively affect pregnancy outcomes in frozen cycles triggering.