ObjectiveTo investigate the relationship between progesterone (P4) levels on the day
of hCG trigger and IVF outcomes.MethodsThis is a retrospective analysis of IVF cycles from January-2013 to
December-2019 from a single center. Women (21-39 years) submitted to IVF
treatment for various infertility factors were included, while donor oocyte
cycles and cancelled cycles were excluded from the study. The primary
outcome measure was live birth rate.ResultsA total of 2149 cycles were analyzed. Of these, 223 (10.38%) were in the low
P4 group (<0.5 ng/ml), 1163 (54.12%) in the normal P4 group (0.5-1.5
ng/ml), and 763 (35.50%) in the high P4 group (>1.5ng/ml). The groups
were comparable with respect to age, factor of infertility and baseline AMH.
The antagonist protocol was significantly more prescribed to the high P4
group (p<0.001). Live birth rates were 14.4%, 21.6%, and 21%
(p<0.001), respectively, in three groups. Univariate analysis found that
total cetrotide dose, total number of retrieved and fertilized oocytes,
total number of embryos formed, transferred, and vitrified, and P4 on the
day of hCG (p<0.001) were statistically significant after adjusting for
age and BMI. In multivariate logistic regression after adjusting for age and
BMI, only high P4 (aOR:0.60; p<0.001), total cetrotide dose (aOR: 0.82;
p<0.001), and total utilizable embryos (aOR:1.11; p=0.029) were
statistically significant.ConclusionsHaving an elevated serum progesterone level on the day of hCG trigger was
associated with lower pregnancy rates, but this is still not a robust marker
to predict live births. More good quality evidence is needed.