The relationship of premature progesterone rise with serum estradiol levels and number of follicles in GnRH antagonist/recombinant FSH-stimulated cycles

Abstract Objective(s) To investigate the relationship between premature progesterone (P) rise and serum estradiol (E2 ) levels and the number of follicles in GnRH antagonist/rec-FSH stimulated cycles. Study design Two hundred and seven patients treated by IVF/ICSI at the Centre for Reproductive Medi...

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Published in:European journal of obstetrics & gynecology and reproductive biology 2012-06, Vol.162 (2), p.165-168
Main Authors: Kyrou, D, Al-Azemi, M, Papanikolaou, E.G, Donoso, P, Tziomalos, K, Devroey, P, Fatemi, H.M
Format: Article
Language:English
Subjects:
Adult
Estradiol
Estradiol - blood
Female
Follicle Stimulating Hormone, Human
Follicles
GnRH antagonist
Gonadotropin-Releasing Hormone - analogs & derivatives
Gonadotropin-Releasing Hormone - antagonists & inhibitors
Humans
Obstetrics and Gynecology
Ovarian Follicle - physiology
Progesterone - blood
Progesterone rise
Reproductive Techniques, Assisted
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Summary:Abstract Objective(s) To investigate the relationship between premature progesterone (P) rise and serum estradiol (E2 ) levels and the number of follicles in GnRH antagonist/rec-FSH stimulated cycles. Study design Two hundred and seven patients treated by IVF/ICSI at the Centre for Reproductive Medicine of the Dutch-Speaking Brussels Free University were included in this observational study. They received 200 IU/day rec-FSH from day 2 of the cycle and daily GnRH antagonist starting on day 6 of stimulation. The criteria for hCG administration included the presence of ≥3 follicles of ≥17 mm diameter. Serum P, E2 and LH were determined on the day of hCG administration. The outcome measure was to identify a threshold of E2 and number of follicles on the day of hCG administration which would define a progesterone rise on the day of hCG administration (cut-off value of 1.5 ng/ml). Result(s) Patients with a P >1.5 ng/ml had significantly higher concentrations of E2 and increased number of follicles on the day of hCG administration compared to those with P ≤1.5 ng/ml. However, patients with a P >1.5 ng/ml the day of hCG showed lower pregnancy rates than those with P 1790.5 pg/ml and more than 9.5 follicles of ≥11 mm in diameter for progesterone rise over 1.5 ng/ml. Conclusion(s) A significant impact is shown on progesterone rise by E2 and number of follicles on the day of hCG administration in GnRH antagonist/rec-FSH-stimulated cycles. With this knowledge, an upcoming progesterone rise during follicular phase can be anticipated and prevented.
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2012.02.025