Serum progesterone concentrations before and after human chorionic gonadotropin triggering and invitro fertilization : Intracytoplasmic sperm injection cycle outcome in long gonadotrophin releasing hormone agonist protocol

Objective: To assess the impact of serum progesterone concentrations before and after HCG triggering on IVF/ICSIcycle outcomes in long GnRHa protocol.Patients and Methods: This is a single-center prospective observational cohort study, in which 102 IVF/ICSI patients with normal cycle day 2 basal hormones were recruited and underwent ovarian stimulation using the long GnRHa protocol. Serum progesterone on the day of HCG trigger; one day after, progesterone/estradiol was assessed and correlated with pregnancy rates, the total dose of used gonadotropins, serum estradiol level on day of trigger, the number of collected oocytes, the number of metaphase II oocytes and the quality of transferred embryos.Results: 96 women were included in the analysis. In our study, the receiver-operating characteristic (ROC) analysis was used to gain more diagnostic accuracy. Our data according to ROC analysis showed that the P levels on the day of hCG trigger, and its levels one day after and P/E2 on the day of hCG trigger had no role in prediction of clinical pregnancy rates. There was significant correlation between the serum progesterone levels before and after HCG triggering with the total dose of gonadotropins used. They also correlated strongly with serum estradiol level on day of trigger, the number of collected oocytes and the number of metaphase II oocytes.Conclusion: Peri-ovulatory serum progesterone concentrations cannot predict pregnancy rates in IVF/ICSI cycles using long GnRHa protocol.