Volume 13, Issue 2 (2-2015)                   IJRM 2015, 13(2): 79-84 | Back to browse issues page

XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Saharkhiz N, Salehpour S, Tavasoli M, Aghighi A. Premature progesterone rise at human chorionic gonadotropin triggering day has no correlation with intracytoplasmic sperm injection outcome. IJRM 2015; 13 (2) :79-84
URL: http://ijrm.ir/article-1-623-en.html
1- Infertility and Reproductive Health Research Center (IRHRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Infertility and Reproductive Health Research Center (IRHRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran , mahboobetavasoli@yahoo.com
3- Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract:   (2870 Views)
Background: Premature luteinization during in vitro fertilization was commonly happened before the introduction of GnRh analogues. High level of unwanted progesterone is associated with adverse pregnancy outcome and is thought to be induced by inappropriate LH elevation.
Objective: To evaluate the progesterone level on the day of Human Chorionic Gonadotropin (HCG) triggering in GnRh agonist and antagonist protocols, and its correlation with clinical pregnancy rate and miscarriage rate.
Materials and Methods: One hundred and seven women underwent intracytoplasmic sperm injection with long agonist protocol (n=46) or antagonist protocol (n=61). Blood sample was obtained from each patient for progesterone level measurement in HCG administration day, then patients were divided into two groups according to their serum progesterone levels on the HCG triggering day: progesterone level <1.2 ng/ml, and progesterone level ≥1.2 ng/ml. Clinical pregnancy and miscarriage rates were evaluated as main outcomes and biochemical pregnancy rate and implantation rate were considered as secondary outcomes.
Results: The increased prevalence rate of premature progesterone (progesterone level ≥1.2 ng/ml) in total patients was 13.1% (14/107) and in long agonist protocol group and antagonist protocol group was 15.2% (7/46) and 11.5% (7/61) respectively. Premature progesterone rise had no significant correlation with clinical pregnancy rate in total patients (p=0.174), agonist protocol (p=0.545), and antagonist protocol (p=0.129). Also premature progesterone rise had no significant association with miscarriage rate in total patients (p=0.077), agonist protocol group (p=0.383) and antagonist protocol group (p=0.087).
Conclusion: A significant rise in progesterone levels at the time of HCG triggering doesn’t lead to decrease in pregnancy rate and implantation rate and increase in miscarriage rate.
Full-Text [PDF 172 kb]   (722 Downloads) |   |   Full-Text (HTML)  (437 Views)  
Type of Study: Original Article |

References
1. Huang R, Fang C, Xu S, Yi Y, Liang X. Premature progesterone rise negatively correlated with live birth rate in IVF cycles with GnRH agonist: an analysis of 2,566 cycles. Fertil Steril 2012; 98: 664-670. [DOI:10.1016/j.fertnstert.2012.05.024]
2. Hamori M, Stuckensen JA, Rumpf D, Kniewald T, Kniewald A, Kurz CS. Premature luteinization of follicles during ovarian stimulation for in-vitro fertilization. Hum Reprod 1987; 2: 639-643. [DOI:10.1093/oxfordjournals.humrep.a136607]
3. Lindheim SR, Cohen MA, Chang PL, Sauer MV. Serum progesterone before and after human chorionic gonadotropin injection depends on the estradiol response to ovarian hyperstimulation during in vitro fertilization-embryo transfer cycles. J Assist Reprod Genet 1999; 16: 242-246. [DOI:10.1023/A:1020311328182]
4. Ochsenkuhn R, Arzberger A, von Schonfeldt V, Gallwas J, Rogenhofer N, Crispin A, et al. Subtle progesterone rise on the day of human chorionic gonadotropin administration is associated with lower live birth rates in women undergoing assisted reproductive technology: a retrospective study with 2,555 fresh embryo transfers. Fertil Steril 2012; 98: 347-354. [DOI:10.1016/j.fertnstert.2012.04.041]
5. Edelstein MC, Seltman HJ, Cox BJ, Robinson SM, Shaw RA, Muasher SJ. Progesterone levels on the day of human chorionic gonadotropin administration in cycles with gonadotropin releasing hormone agonist suppression are not predictive of pregnancy outcome. Fertil Steril 1990; 54: 853-857. [DOI:10.1016/S0015-0282(16)53945-4]
6. Silverberg KM, Martin M, Olive DL, Burns WN, Schenken RS. Elevated serum progesterone levels on the day of human chorionic gonadotropin administration in in vitro fertilization cycles do not adversely affect embryo quality. Fertil Steril 1994; 61: 508-13. [DOI:10.1016/S0015-0282(16)56584-4]
7. Ubaldi F, Camus M, Smitz J, Bennink HC, Van Steirteghem A, Devroey P. Premature luteinization in in vitro fertilization cycles using gonadotropin releasing hormone agonist (GnRH-a) and recombinant follicle-stimulating hormone (FSH) and GnRH-a and urinary FSH. Fertil Steril 1996; 66: 275-280. [DOI:10.1016/S0015-0282(16)58453-2]
8. Bosch E, Valencia I, Escudero E, Crespo J, Simon C, Remohi J, et al. Premature luteinization during gonadotropin-releasing hormone antagonist cycles and its relationship with in vitro fertilization outcome. Fertil Steril 2003; 80: 1444-1449. [DOI:10.1016/j.fertnstert.2003.07.002]
9. Lee FK, Lai TH, Lin TK, Horng SG, Chen SC. Relationship of progesterone/estradiol ratio on day of hCG administration and pregnancy outcomes in high responders undergoing in vitro fertilization. Fertil Steril 2009 Oct; 92: 1284-1289. [DOI:10.1016/j.fertnstert.2008.08.024]
10. Kiliçdag EB, Haydardedeoglu B, Cok T, Hacivelioglu SO, Bagis T. Premature progesterone elevation impairs implantation and live birth rates in GnRH-agonist IVF/ICSI cycles. Arch Gynecol Obstet 2010; 281: 747-752. [DOI:10.1007/s00404-009-1248-0]
11. Nayak S, Ochalski ME, Fu B, Wakim KM, Chu TJ, Dong X, et al. Progesterone level at oocyte retrieval predicts in vitro fertilization success in a short-antagonist protocol: a prospective cohort study. Fertil Steril 2014; 101; 676-682. [DOI:10.1016/j.fertnstert.2013.11.022]
12. Doldi N, Marsiglio E, Destefani A, Gessi A, Merati G, Ferrari A. Elevated serum progesterone on the day of HCG administration in IVF is associated with a higher pregnancy rate in polycystic ovary syndrome. Hum Reprod 1999; 14: 601-605. [DOI:10.1093/humrep/14.3.601]
13. Legro RS, Ary BA, Paulson RJ, Stanczyk FZ, Sauer MV. Premature luteinization as detected by elevated serum progesterone is associated with a higherpregnancy rate in donor oocyte in-vitro fertilization. Hum Reprod 1993; 8: 1506-1511. [DOI:10.1093/oxfordjournals.humrep.a138288]
14. Miller KF, Behnke EJ, Arciaga RL, Goldberg JM, Chin NW, Awadalla SG. The significance of elevated progesterone at the time of administration of human chorionic gonadotropin may be related to luteal support. J Assist Reprod Genet 1996; 13: 698-701. [DOI:10.1007/BF02066420]
15. Lai TH, Lee FK, Lin TK, Horng SG, Chen SC, Chen YH, et al. An increased serum progesterone-to-estradiol ratio on the day of human chorionic gonadotropin administration does not have a negative impact on clinical pregnancy rate in women with normal ovarian reserve treated with a long gonadotropin releasing hormone agonist protocol. Fertil Steril 2009; 92: 508-514. [DOI:10.1016/j.fertnstert.2008.06.036]
16. Saleh HA, Omran MS, Draz M. Does subtle progesterone rise on the day of HCG affect pregnancy rate in long agonist ICSI cycles? J Assist Reprod Genet 2009; 26: 239-242. [DOI:10.1007/s10815-009-9309-7]
17. Venetis CA, Kolibianakis EM, Tarlatzis BC. Progesterone elevation andprobability of pregnancy after IVF: facts and fiction. Hum Reprod Update 2008; 14: 538. [DOI:10.1093/humupd/dmn027]
18. Younis JS. ''Premature luteinization'' in the era of GnRH analogue protocols: time to reconsider. J Assist Reprod Genet 2011; 28: 689-692. [DOI:10.1007/s10815-011-9585-x]
19. Elnashar AM. Progesterone rise on the day of HCG administration (premature luteinization) in IVF: an overdue update. J Assist Reprod Genet 2010; 27: 149-155. [DOI:10.1007/s10815-010-9393-8]
20. Hofmann GE, Bentzien F, Bergh PA, Garrisi GJ, Williams MC, Guzman I, et al. Premature luteinization in controlled ovarian hyper stimulation has no adverse effect on oocyte and embryo quality. Fertil Steril 1993; 60: 675-679. [DOI:10.1016/S0015-0282(16)56221-9]
21. Younis JS, Simon A, Laufer N. Endometrial preparation: lessons from oocyte donation. Fertil Steril 1996; 66: 873-884. [DOI:10.1016/S0015-0282(16)58677-4]
22. Copperman AB, Horowitz GM, Kaplan P, Scott RT, Navot D, Hofmann GE. Relationship between circulating human chorionic gonadotropin levels and premature luteinization in cycles of controlled ovarian hyperstimulation. Fertil Steril 1995; 63: 1267-1271. [DOI:10.1016/S0015-0282(16)57609-2]
23. Ubaldi F, Albano C, Peukert M, Riethmuller-Winzen H, Camus M, Smitz J, et al. Subtle progesterone rise after the administration of the gonadotrophin releasing hormone antagonist cetrorelix in intracytoplasmic sperm injection cycles. Hum Reprod 1996; 11: 1405-1407. [DOI:10.1093/oxfordjournals.humrep.a019409]
24. Younis JS, Matilsky M, Radin O, Ben-Ami M. Increased progesterone/estradiol ratio in the late follicular phase could be related to low ovarian reserve in in vitro fertilization- embryo transfer cycles with a long gonadotropin releasing hormone agonist. Fertil Steril 2001; 76: 294-299. [DOI:10.1016/S0015-0282(01)01918-5]
25. Pangas SA, Li X, Robertson EJ, Matzuk MM. Premature luteinization and cumulus cell defects in ovarian-specific Smad4 knockout mice. Mol Endocrinol 2006; 20: 1406-1422. [DOI:10.1210/me.2005-0462]
26. Schoolcraft W, Sinton E, Schlenker T, Huynh D, Hamilton F, Meldrum DR.Lower pregnancy rate with premature luteinization during pituitary suppression with leuprolide acetate. Fertil Steril 1991; 55: 563-566. [DOI:10.1016/S0015-0282(16)54186-7]
27. Check JH, Lurie D, Askari HA, Hoover L, Lauer C. The range of subtle rise in serum progesterone levels following controlled ovarian hyperstimulation associated with lower in vitro fertilization pregnancy rates is determined by the source of manufacturer. Eur J Obstet Gynecol Reprod Biol 1993; 52: 205-209. [DOI:10.1016/0028-2243(93)90073-L]
28. Lahoud R, Kwik M, Ryan J, Al-Jefout M, Foley J, Illingworth P. Elevated progesterone in GnRH agonist down regulated in vitro fertilization (IVFICSI) cycles reduces live birth rates but not embryo quality. Arch Gynecol Obstet 2012; 285: 535-540. [DOI:10.1007/s00404-011-2045-0]
29. Fanchin R, Hourvitz A, Olivennes F, Taieb J, Hazout A, Frydman R. Premature progesterone elevation spares blastulation but not pregnancy rates in in vitro fertilization with co culture. Fertil Steril 1997; 68: 648-652. [DOI:10.1016/S0015-0282(97)80464-5]
30. Papanikolaou EG, Kolibianakis EM, Pozzobon C, Tank P, Tournaye H, Bourgain C, et al. Progesterone rise on the day of human chorionic gonadotropin administration impairs pregnancy outcome in day 3 single-embryo transfer, while has no effect on day 5 single blastocyst transfer. Fertil Steril 2009; 91: 949-952. [DOI:10.1016/j.fertnstert.2006.12.064]
31. Fanchin R, de Ziegler D, Taieb J, Hazout A, Frydman R. Premature elevation of plasma progesterone alters pregnancy rates of in vitro fertilization and embryo transfer. Fertil Steril 1993; 59: 1090-1094. [DOI:10.1016/S0015-0282(16)55933-0]

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb