Premature progesterone rise on day of hCG negatively correlated with live birth rate in IVF cycles: An analysis of 1022 cycles

Objective. - To investigate the relationship between serum P levels on the day of hCG administration and pregnancy outcomes in patients undergoing IVF. Design. - Retrospective study. Setting. - Teaching hospital. Patients. - A total of 1022 IVF-ICSI cycles, frozen embryo transfer excluded. Intervention(s). - Patients-all types of responder - underwent IVF with agonist or antagonist protocols. Clinical outcomes of IVF were analyzed according to plasma P levels. Main outcome measure(s). - Ongoing pregnancy rates. Results. - We proposed a serum P level of 1.57 ng/ml on day of hCG as a threshold for all types of responders and all protocols combined. Ongoing implantation rates were not affected by elevated progesterone. Live birth rate was inversely associated with serum P levels on day of hCG and more miscarriages were associated with P > 1.57 ng/ml. We have not found the progesterone > 1.57 ng/ml on the day of hCG as a prognostic factor for pregnancy. Conclusion(s). - Elevated P level on the day of hCG administration negatively influence live birth rate and is correlated to an increase of miscarriage. The detrimental effect of P elevation on pregnancy seems not to be related substantially to endometrium receptivity. Thus, despite a comparable clinical pregnancy rate and an initial implantation rate, we demonstrate more spontaneous abortion and it would seem that the effect of progesterone is later. (C) 2018 Published by Elsevier Masson SAS.