Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (5): 44-50.doi: 10.6040/j.issn.1671-7554.0.2023.0055

• 临床医学 • Previous Articles    

Relationship between the number of retrieved oocytes and IVF outcomes correlated with elevated progesterone on hCG day

XU Yueming1, ZHANG Jie1, JIANG Lei1, YIN Li2, ZHAO Pan1, XU Xin1, HAO Guimin1   

  1. 1. Department of Reproduction;
    2. Department of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China
  • Published:2023-05-15

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Abstract: Objective To investigate the effects of progesterone elevation on the day of human chorionic gonadotropin(hCG)administration on in vitro fertilization(IVF)pregnancy outcomes, and to explore the relationship between the number of retrieved oocytes and IVF outcomes correlated with elevated progesterone. Methods A total of 2,437 patients who underwent IVF/intracytoplasmic sperm injection(ICSI)treatment cycles during Jan. 2019 and Dec. 2020 were retrospectively enrolled. The effects of progesterone elevation on IVF pregnancy outcomes were determined with univariate regression analysis, multivariate Logistic regression analysis, smoothed curve fitting and threshold effects, and whether the effects were related to the number of retrieved oocytes was assessed with stratified analysis. Results After confounding factors were adjusted, analysis of threshold effects showed when the progesterone level was ≥1.5 ng/mL on hCG day, with a 1 ng/mL increase in the progesterone level, the clinical pregnancy rate decreased by 60%(95%CI: 0.2-0.7, P=0.004), the intrauterine pregnancy rate decreased by 70%(95%CI: 0.2-0.7, P=0.003), and the live birth rate decreased by 70%(95%CI: 0.1-0.7, P=0.004). After grouping according to the number of retrieved oocytes, when the number of retrieved oocytes was 5-10 and the progesterone level was ≥1.8 ng/mL on hCG day, with a 1 ng/mL increase in the progesterone level, the clinical pregnancy rate decreased by 100%(95%CI: 0.0-0.1, P=0.002), and the intrauterine pregnancy rate decreased by 100%(95%CI: 0.0-0.010, P<0.001). When the progesterone level was ≥1.6 ng/mL on hCG day, with a 1 ng/mL increase in the progesterone level, the live birth rate decreased by 90%(95%CI: 0.0-1.0, P=0.049). When the number of retrieved oocytes was 10-15 and the progesterone level was ≥1.1 ng/mL on hCG day, with a 1 ng/mL increase in the progesterone level, the clinical pregnancy rate decreased by 70%(95%CI: 0.1-0.7, P=0.006), the intrauterine pregnancy rate decreased by 70%(95%CI: 0.1-0.6, P=0.003), and the live birth rate decreased by 70%(95%CI: 0.1-0.6, P=0.003). Conclusion Elevated progesterone level on hCG day is an independent risk factor affecting the IVF pregnancy outcomes. There is a remarkable effect on patients with the number of oocytes 5-15 with elevated progesterone. So the pregnancy outcomes of normal ovarian response patients can be improved by freezing all embryos when the progesterone level is more than 1.5 ng/mL.

Key words: Elevated progesterone, In vitro fertilization, Fresh embryo transfer, Pregnancy outcome, Number of retrieved oocytes

CLC Number: 

  • R711.6
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