Premature Progesterone Elevation Does Not Affect Pregnancy Outcome in High-Responder Patients Undergoing Short-Interval Coasting in IVF Cycles
Mustafa Acet, Lebriz Hale Aktün, Serdar Başaranoğlu, Betül Yorgunlar, Tuba Acet, Aysegul Deregözü
Department of Obstetrics and Gynecology, Medipol University, School of Medicine, Istanbul, Turkey
Med Sci Monit Basic Res 2015; 21:247-252
We aimed to present the relationship between premature progesterone elevation (PPE) and clinical outcomes in high-responder patients who had a coasting period of <4 days in length due to their high risk of developing ovarian hyperstimulation syndrome (OHSS) and who were treated with a long-acting gonadotropin-releasing hormone agonist (GnRH-agonist) protocol in in vitro fertilization-embryo transfer (IVF-ET) cycles.
MATERIAL AND METHODS: This retrospective study was conducted at the University Hospital Assisted Reproductive Technology Center. The outcomes of 101 patients undergoing IVF- intracytoplasmic sperm injection (ICSI) cycles who showed a high response to COH (estradiol >4000 pg/ml and/or >20 follicles each ≥10 mm in diameter and at least 20% ≥15 mm) and who were coasted for <4 days were evaluated. Number of oocytes, 2 pronuclei (PN) embryos, implantation rate, and live birth rate were measured.
RESULTS: The incidence of PPE was 32.6%. Compared with those without PPE, patients with PPE had a higher number of oocytes retrieved. Total mature and fertilized oocytes and the mean number of embryos transferred were not significantly different between groups. Live birth rates (41.9% vs. 38.7%) and implantation rates (26.5% vs. 23%) were also not significantly divergent in the PPE and non-PPE groups, respectively.
CONCLUSIONS: P concentrations ≥1.3 ng/ml on the day of human chorionic gonadotropin (hCG) administration, designated in this study as PPE, does not appear to be related to adverse effects in terms of clinical outcomes in high-responder patients undergoing coasting <4 days due to their high risk of developing OHSS treated with a long-acting GnRH-a protocol in IVF-embryo transfer cycles.
Keywords: Chorionic Gonadotropin - administration & dosage, Adult, Embryo Transfer - methods, Estradiol - blood, Gonadotropin-Releasing Hormone - agonists, Ovarian Hyperstimulation Syndrome - prevention & control, Ovulation Induction - methods, Pregnancy, Pregnancy Outcome, Progesterone - blood, Sperm Injections, Intracytoplasmic - methods