Effect of progesterone/estradiol ratio on pregnancy outcome of patients with high trigger-day progesterone levels undergoing gonadotropin-releasing hormone antagonist intracytoplasmic sperm injection cycles: a retrospective cohort study

Ömeroğlu, İbrahim; İnce, Onur; Gölbaşı, Ceren; Özer, Mehmet Caner; Demir, Mustafa; Yılmaz, Bülent

doi:10.1080/01443615.2018.1504204

Cited by 15 publications

(11 citation statements)

References 22 publications

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“…These hormones may act in concert for synergistic immune effects, with low estradiol to progesterone ratio exerting a protective effect on MS disease activity. Notably, during the third trimester of pregnancy, i.e., when clinical and MRI disease activity is suppressed ( 81 – 84 ), the progesterone/estradiol ratio appears low to reduce the risks of an adverse pregnancy outcome ( 85 , 86 ). Likewise, a negative correlation was observed between concentrations of the male hormone testosterone and both tissue damage as detected on MRI and neurological impairment ( 49 , 87 – 89 ).…”

Section: Clinical and Radiological Evidence Of Sexual Dimorphism In Mmentioning

confidence: 99%

SeXX Matters in Multiple Sclerosis

2020

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Multiple sclerosis (MS) is the most common chronic inflammatory and neurodegenerative disease of the central nervous system (CNS). An interesting feature that this debilitating disease shares with many other inflammatory disorders is that susceptibility is higher in females than in males, with the risk of MS being three times higher in women compared to men. Nonetheless, while men have a decreased risk of developing MS, many studies suggest that males have a worse clinical outcome. MS exhibits an apparent sexual dimorphism in both the immune response and the pathophysiology of the CNS damage, ultimately affecting disease susceptibility and progression differently. Overall, women are predisposed to higher rates of inflammatory relapses than men, but men are more likely to manifest signs of disease progression and worse CNS damage. The observed sexual dimorphism in MS may be due to sex hormones and sex chromosomes, acting in parallel or combination. In this review, we outline current knowledge on the sexual dimorphism in MS and discuss the interplay of sex chromosomes, sex hormones, and the immune system in driving MS disease susceptibility and progression.

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Section: Clinical and Radiological Evidence Of Sexual Dimorphism In Mmentioning

confidence: 99%

SeXX Matters in Multiple Sclerosis

2020

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“…Increasing number of studies used other indicators, such as progesterone hCG /progesterone basal [ 24 ], P/E2 [ 19 , 25 , 26 ], progesterone /follicle [ 19 ], progesterone /mature oocytes [ 27 ], to predict pregnancy outcome. However, the serum elevated progesterone level would induce endometrial transformation, weaken the endometrium receptivity [ 28 ], and cause the asynchrony between the endometrium and the embryo [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of slightly elevated progesterone on hCG trigger day on clinical pregnancy rate in GnRH-ant IVF/ICSI cycles

Zhao

Hao

et al. 2022

Reprod Health

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Background It was been agreed that significantly elevated progesterone level on the hCG trigger day have detrimental effect on clinical outcomes in IVF/ICSI cycles. However, few studies explored whether slightly elevated progesterone level also same impact on clinical outcomes. Methods We retrospectively studies the effect of slightly elevated progesterone level on outcomes of IVF/ICSI in GnRH-ant cycles. Propensity score matching was used to confounding variables. The women were divided into two groups according to the progesterone level: Group 1: < 1.0 ng/ml; Group 2: 1.0 ng/ml–1.5 ng/ml. Then compare the clinical pregnancy rate (CPR) between the two groups. Result A total of 847 IVF/ICSI cycles were included in the present study. The average CPR per transfer cycle was 51.7%. CPR of group 1 was 55.22%, significantly higher than that of group 2 (40.66%, P = 0.013). Progesterone level on the day of hCG injection was further evaluated at threshold increments of 0.1 ng/ml, and the CPR was decreased dramatically once the progesterone level higher than 1.4 ng/ml. Conclusion The slight elevation progesterone level on the hCG trigger day may have a negative effect on the clinical pregnancy in GnRH-ant cycles. In the case of progesterone > 1.4 ng/ml on the hCG injection day, freeze-all strategy was recommended. Summary The present retrospective study aimed to evaluate the effect of slightly elevated progesterone (1.0 ng/ml ~ 1.5 ng/ml) on outcomes of IVF/ICSI in GnRH-ant cycles. Slightly elevated progesterone level leaded to significant lower clinical pregnancy rate (CPR) that that of group with normal progesterone level (40.66% vs. 55.22%, P = 0.013). The CPR was decreased dramatically once the progesterone level higher than 1.4 ng/ml. So slightly elevated progesterone level on the trigger day may have a negative effect on the clinical pregnancy in GnRH-ant cycles. In the case of progesterone > 1.4 ng/ml on the hCG injection day, freeze-all strategy was recommended.

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“…Golbasi et al . [ 32 ] demonstrated that P/E2 is not a significant predictive factor for the live birth rate after a retrospective analysis of 176 fresh ET of GnRH antagonist ICSI cycles with serum P ≥ 1.5 ng/ml. However, the study did not define specific ET day (2 nd , 3 rd , and 5 th days' embryos).…”

Section: Discussionmentioning

confidence: 99%

Progesterone/Oestradiol ratio can better predict intracytoplasmic sperm injection outcomes than absolute progesterone level

et al. 2021

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Background: Several parameters were proposed to predict the impact of premature luteinization on intracytoplasmic sperm injection (ICSI) outcomes such as isolated progesterone (P) level, progesterone to oocyte ratio, and progesterone/estradiol ratio (P/E2). Aim: The aim of this study is to compare the predictive value of P/E2 ratio and isolated P level on the ovulation triggering day for pregnancy outcomes in fresh GnRH antagonist ICSI cycles. Settings and Design: A retrospective cohort study conducted in a university-affiliated in vitro fertilization center between January 2017 and April 2019. Methods: The study included women who underwent their first- or second-ranked GnRH antagonist ICSI cycles with day-3 embryo transfer. P/E2 ratio was calculated as (P [ng/mL] × 1000)/E2 (pg/mL). Cutoff values of ≥1.5 ng/ml for high P (HP) and ≥0.55 for HP/E2 ratio were chosen based on the literature. Statistical Analysis: A receiver operating curve was performed to detect the predictability of serum P/E2 and P for the ongoing pregnancy rate. First, patients were divided according to either P level (low P < 1.5 ng/mL and HP ≥1.5 ng/mL) or P/E2 ratio (low P/E2 <0.55 and HP/E2 ≥ 0.55). Patients were further divided into four subgroups: (Group A: HP and HP/E2 ratio, Group B: low P and low P/E2 ratio, Group C: HP only, and Group D: HP/E2 only). A multivariate regression analysis models were used to account for the effect of the cycle confounders on the likelihood of pregnancy. Results: A total of 402 ICSI cycles were analyzed. The area under the curve was 0.67 and 0.59 for P/E2 and P, respectively. P/E2 showed a significant association with ongoing pregnancy (adjusted odds ratios [aOR]: 0.409, 95% confidence interval [CI] 0.222–0.753, P = 0.004) while HP revealed no significant predictive value (aOR: 0.542, 95% CI 0.284–1.036, P = 0.064) after the multivariate analysis. Conclusions: P elevation may not present as an independent predictor for cycle outcomes. P/E2 ratio has a better prognostic value than P alone in predicting pregnancy of GnRH antagonist cycles.

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Effect of progesterone/estradiol ratio on pregnancy outcome of patients with high trigger-day progesterone levels undergoing gonadotropin-releasing hormone antagonist intracytoplasmic sperm injection cycles: a retrospective cohort study

Cited by 15 publications

References 22 publications

SeXX Matters in Multiple Sclerosis

SeXX Matters in Multiple Sclerosis

Effect of slightly elevated progesterone on hCG trigger day on clinical pregnancy rate in GnRH-ant IVF/ICSI cycles

Progesterone/Oestradiol ratio can better predict intracytoplasmic sperm injection outcomes than absolute progesterone level

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