Effect of hCG-day estradiol and progesterone on intracytoplasmic sperm injection outcome

Aim We conducted this prospective study to measure hCG-day E2 and progesterone (P) and assess their ability to predict ovarian response and clinical pregnancy in patients undergoing their first ICSI cycle. Patients and methods A total of 100 infertile women, aged between 20 and 39 years, undergoing ICSI at a private hospital in Cairo (between June 2013 and June 2014) were included in the study. hCG-day E2 and progesterone levels were recorded on the day of hCG administration and correlated with MII oocyte yield and pregnancy rate. Receiver-operating characteristic curves for progesterone and estrogen were constructed to predict clinical pregnancy. Results The mean value of serum progesterone on the day of hCG injection was 0.35±0.19 ng/ml in the pregnant group and 0.51±0.25 ng/ml in the nonpregnant group (P=0.003). hCG-day progesterone correlated negatively with the number of MII oocytes (r=−0.2, P=0.038) and negatively with pregnancy (r=−0.29, P=0.002). E2 showed insignificant correlation with MII and pregnancy rate. Receiver-operating characteristic curve analysis for P showed a sensitivity of 63.6%, specificity of 61.2%, positive predictive value of 44.7%, and negative predictive value of 77.4%, at a cutoff value of less than or equal to 0.37. Conclusion hCG-day progesterone was significantly higher in the nonpregnant group and was detrimental on the number of MII oocytes and on clinical pregnancy. Estradiol showed an insignificant correlation with both MII and clinical pregnancy.