Early Progesterone Change Associated With Pregnancy Outcome After Fresh Embryo Transfer in Assisted Reproduction Technology Cycles With Progesterone Level of > 1.5 ng/ml on Human Chorionic Gonadotropin Trigger Day

doi:10.3389/fendo.2020.00653

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24336

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题名:	Early Progesterone Change Associated With Pregnancy Outcome After Fresh Embryo Transfer in Assisted Reproduction Technology Cycles With Progesterone Level of > 1.5 ng/ml on Human Chorionic Gonadotropin Trigger Day
作者:	Lee, CI;Chen, HH;Huang, CC;Lin, PY;Lee, TH;Lee, MS
关键词:	progesterone elevation;fresh embryo transfer;hCG administration;live birth;assisted reproduction technology
日期:	2020
上传时间:	2022-08-09T08:00:38Z (UTC)
出版者:	FRONTIERS MEDIA SA
ISSN:	1664-2392
摘要:	Several studies have reported a poor implantation rate for assisted reproduction technology (ART) cycles with elevated progesterone (P4) at the end of the follicular phase. Whether all women with increased P4 on the human chorionic gonadotropin(hCG) trigger day should undergo fresh or frozen embryo transfer (ET) remains to be explored. This study attempted to determine that the P4 level on 2 days before hCG administration and P4 ratio can serve as indicators for fresh ET in normal responders with an elevated P4 level of >1.5 ng/ml on the hCG administration day. This was a retrospective cohort study involving 337 ART cycles with fresh ET for normal responders. Serum P4 levels were measured 2 days prior to hCG day (P4 level I) and on the hCG administration day (P4 level II). The P4 ratio was calculated as follows: P4 ratio = P4 level II / P4 level I. The primary outcome is live birth rate of fresh ET cycles. The ROC curves established that the optimal P4 level I and P4 ratio for pregnancy in ART cycles with high P4 level II were 0.975 ng/ml and 1.62, respectively. Patients with a P4 level I of <= 0.975 ng/ml and P4 ratio of >1.62 were associated with a significantly higher implantation (30.8%, 61/198 vs. 10.3%, 19/184,p< 0.001) and live birth rates (51.6%, 33/64 vs. 15.0%, 9/60,p< 0.001) compared with those with a P4 level I of >0.975 ng/ml and P4 ratio of <= 1.62. A combination of P4 level I and P4 ratio cutoff values of 0.975 ng/ml and 1.62, respectively, had a positive predictive value (PPV) of 82.5% for pregnancy. In conclusion, fresh ET can be an option for women with an early P4 level I under 0.975 ng/ml and a P4 ratio higher than 1.62, especially for those normal responders with an elevated P4 level II >1.5 ng/ml on the hCG administration day. This approach may shorten the time to pregnancy and reduce the cost of ART cycles.
URI:	http://dx.doi.org/10.3389/fendo.2020.00653 https://www.webofscience.com/wos/woscc/full-record/WOS:000575972800001 https://ir.csmu.edu.tw:8080/handle/310902500/24336
關聯:	FRONTIERS IN ENDOCRINOLOGY ,2020 ,v11
显示于类别:	[中山醫學大學研究成果] 期刊論文

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