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49A - Progesterone Levels Should Be Measured on the Day of hCG Administration

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from Section IX - Hormones and the Environment

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

Although the impact of high serum P levels the day of triggering on IVF cycle outcome has been extensively reported, its determination is not fully implemented in daily practice. Indeed, some authors argue that this is not justified. In this text you´ll find a different approach to the analysis of the causal-effect relation of serum P and cycle outcome, to demonstrate that P levels should be measured on the day of hCG administration, when a fresh embryo transfer is planned. The 9 Bradford–Hill criteria described to analyze the potential cause–effect relation between two events are reviewed, and moreover, shown to be accomplished by the relationship between high serum P levels and pregnancy rates. Therefore, it is concluded that a simple low-cost practice as serum P determination leads to significant improvement of cycle outcome, and consequently both patients’ and practitioners’ satisfaction.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2021

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References

Hill, AB. The environment and disease: association or causation? Proc Royal Soc Med. 1965;58:295300.CrossRefGoogle ScholarPubMed
Venetis, CA, Kolibianakis, EM, Bosdou, JK, Tarlatzis, BC. Progesterone elevation and probability of pregnancy after IVF: a systematic review and meta-analysis of over 60,000 cycles. Hum Reprod Update. 2013;19:433–57.CrossRefGoogle Scholar
Bosch, E, Labarta, E, Crespo, J, et al. Circulating progesterone levels and ongoing pregnancy rates in controlled ovarian stimulation cycles for in vitro fertilization: analysis of over 4000 cycles. Hum Reprod. 2010;5:2092–100.Google Scholar
Labarta, E, Mariani, G, Holtmann, N, Celada, P, Remohí, J, Bosch, E. Low serum progesterone on the day of embryo transfer is associated with a diminished ongoing pregnancy rate in oocyte donation cycles after artificial endometrial preparation: a prospective study. Hum Reprod. 2017;32:2437–42.CrossRefGoogle ScholarPubMed
Bosch, E, Valencia, I, Escudero, E, et al. Premature luteinization during gonadotropin-releasing hormone antagonist cycles and its relationship with in vitro fertilization outcome. Fertil Steril. 2003;80:1444–9.CrossRefGoogle ScholarPubMed

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