Influence of Progesterone/Estradiol Ratio on Luteal Function for Achieving Pregnancy in Gonadotropin Therapy

Abstract

The purpose of this study was to evaluate the influence of the relationship between plasma progesterone (P₄) and estradiol (E₂) levels in the luteal phase for achieving pregnancy in human menopausal gonadotropin (hMG)-human chorionic gonadotropin (hCG)-treated cycles. Plasma P₄ and E₂ levels were determined in 93 hMG-hCG-treated cycles (23 pregnant and 70 nonpregnant) of 46 patients during 3 periods of the luteal phase, using radioimmunoassay. In addition, 88 spontaneous ovulatory cycles and 100 clomiphene-treated cycles were also studied in the same manner. In hMG-hCG-treated cycles in the early luteal phase, the P₄/E₂ ratio in pregnant cycles was significantly higher than that in nonpregnant cycles. There was no significant difference between the P₄/E₂ratios of the luteal phase of hMG-hCG-treated pregnant-group, clomiphene-treated and spontaneous ovulatory cycles. In nonpregnant cycles, however, the P₄/E₂ ratio in hMG-hCG-treated cycles was significantly lower than that in clomiphene-treated or spontaneous ovulatory cycles. These results suggest that in hMG-hCG-treated cycles, the P₄/E₂ ratio may be a more reliable index of luteal function for achieving pregnancy than P₄ levels alone.

The use of estradiol for luteal phase support in in vitro fertilization/intracytoplasmic sperm injection cycles: a systematic review and meta-analysis

“…Some small retrospective studies have suggested that a high luteal P4/E 2 ratio may be a reliable index of successful pregnancy in ovulation induction cycles (37,38). On the contrary, other investigators have found no correlation between the luteal P4/E 2 ratio and pregnancy in IVF cycles (39).…”

The selection criteria on an IVF program can remove the association between maternal age and implantation

“…There was a suggestion of lower implantation rates in the youngest and oldest age bands. It may be speculated that some younger patients are more likely to respond excessively to HMG stimulation (26) and hence not acquire optimum endometrial priming (15). Our oldest age band (4145 yrs) contained a greater proportion of patients who required a higher dose of HMG/FSH stimulation to achieve an adequate ovarian response (Table V).…”

A comparison of the effects of three different luteal phase support protocols on in vitro fertilization outcomes: a randomized clinical trial

“…In our study, we did not observe a difference between the P levels of the groups on days 7 and 10 of the luteal phase. Some studies report the E 2 /P rate to have a role in successful pregnancy outcomes in ovulation induction cycles (31,32). In the study of Gruber et al (33) on IVF cycles, with respect to the E 2 /P rate, pregnant patients had higher rates on all 3 days (33).…”