Abstract:

BACKGROUND: Controlled ovarian hyperstimulation makes more follicular development, and serum progesterone and estradiol levels are significantly higher than natural menstrual cycles. However, it remains controversial whether this can change oocyte quality and endometrial receptivity, and reduce the implantation rate and clinical pregnancy rate.
OBJECTIVE: To discuss the effect of serum estradiol and progesterone level and progesterone/estradiol (P/E2) ratio on the day of human chorionic gonadotropin (HCG) administration in pregnancy outcome of in vitro fertilization (IVF)-embryo transplantation (EF).
METHODS: A retrospective analysis was performed in the medical records of 218 patients undergoing IVF-ET treatment. Patients were divided into three groups according to serum estradiol concentration: E2 < 3 000 ng/L; 3 000 ng/L ≤ E2 <         5 000 ng/L and E2 ≥ 5 000 ng/L on the day of HCG administration. According to serum progesterone concentration: P ≤ 0.9 ng/L; 0.9 ng/L < P ≤ 3 ng/L and P > 3 ng/L. According to P/E2 ratio: P/E2 ratio > 1 and P/E2 ratio ≤ 1. The implantation rate and clinical pregnancy rate were analyzed.
RESULTS AND CONCLUSION: With the increased E2 levels and P/E2 ratio, the implantation rate and clinical pregnancy rate were slightly declined (P > 0.05). The implantation rate and clinical pregnancy rate were significantly decreased in P > 3 ng/L group than the other two groups (P < 0.01). Results show that serum progesterone levels on the day of HCG administration have an adverse effect on implantation rate and clinical pregnancy rate in IVF-ET cycles.