Influence of the Postovulatory Progesterone on the Outcome of In Vitro Fertilization

Aim: To investigate the influence of postovulatory progesterone (P4) on the outcome of in vitro fertilization (IVF). Materials and methods: This was a prospective cohort study which included 400 patients (300 in the control group and 100 in the group with elevated preovulatory P4 (preovulatory P4 > 4.77 nmol/L) - 85 normal responders and 15 high responders). The influence of postovulatory P4 on the IVF outcome has been investigated in this study. Results: It was found that the P4 value on the fifth cycle day at a concentration ≤425.7 nmol/L has a high sensitivity (86.21%, 95% CI 81.7-90.0%) and a low specificity (23.64%, 95% CI 16.1-32.7%) in all patients in the study. The obtained results showed that P4 values on day 5 >425,7 nmol/L in all patients, and the P4 on the 5th day >384,6 nmol/L among patients with elevated preovulatory P4 represent a threshold for the successful IVF procedure (positive ultrasound visualization of the gestational sac at six weeks of pregnancy with the presence of fetal heart action after embryo transfer). Conclusion: The P4 on the fifth day >425,7 nmol/L could be a potential marker for the success of the IVF procedures among all the patients, and with P4 on the fifth day >384,6 nmol/L among patients with elevated preovulatory P4.