Objective: Our purpose was to assess and clarify the mechanism of whether an early progesterone rise in cycles with gonadotropin-releasing hormone agonist (GnRH-a) is associated with an impairment of IVF outcome
Methods: Seven hundred eighty-six cycles were induced with GnRH-a and human menopausal gonodotropin (hMG) (
long protocol
). Plasma progesterone (PP) levels on the day of human chorionic gonadotropin (hCG) administration were divided into three groups: <0.9 ng/ml="" (group="" a),="" 1–2="" ng/ml="" (group="" b),="" and="">2 ng/ml (Group C). We also analyzed the pregnancies achieved in our egg donation protocol in relation to the PP levels of each donor on the day of hCG administration.
Results: Group A involved 525 cycles, Group B had 223, and Group C had 38. The overall pregnancy rate per egg transfer was 19.2%, with the highest for Group A (22.3%), declining for Groups B (14.3%) and C (7.9%) (A = B = C; P<0.005). the="" embryo="" implantation="" rate="" was="" found="" to="" be="" negatively="" correlated="" with="" the="" pp="" levels="" on="" the="" day="" of="" hcg="" administration.="" in="" contrast,="" there="" was="" an="" opposite="" trend="" between="" pp="" levels="" and="" the="" chance="" of="" conception="" in="" 30="" pregnancies="" achieved="" by="" egg="">
Conclusions: Since premature luteinization is very unlikely to occur under the conditions of this study, our findings suggest that an early PP rise has a negative impact on endometrial receptivity but not on egg and embryo quality.
Key words Gonadotropin releasing hormone agonist/human menopausal gonadotropin - progesterone