AUTHOR=De Cesare Raffaella , Morenghi Emanuela , Cirillo Federico , Ronchetti Camilla , Canevisio Valentina , Persico Paola , Baggiani Annamaria , Sandri Maria Teresa , Levi-Setti Paolo Emanuele 

TITLE=The Role of hCG Triggering Progesterone Levels: A Real-World Retrospective Cohort Study of More Than 8000 IVF/ICSI Cycles

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 11 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.547684

DOI=10.3389/fendo.2020.547684

ISSN=1664-2392

ABSTRACT=Objective: To assess the association between serum ovulation trigger progesterone (P) levels and the outcome of in vitro fertilization cycles.
Design setting: Single-center retrospective cohort study.
Patients Intervention(s):  All fresh cleavage and blastocyst stage embryo transfers (ET) performed from January 2012 to December 2016.
Main outcome measure(s): The impact of premature high serum P levels cycles in terms of Clinical Pregnancy Rates (CPR) and Live Birth Rates (LBR).
Results: 8,034 ET were performed: 7,597 cleavage-stage transfers and 437 blastocyst transfers. Serum P levels demonstrated to be inversely related to CPR (OR 0.72, p<0.001) and LBR (OR 0.73, p<0.001). The progressive decrease LBR and CPR started when P levels were 1 ng/mL in a good prognosis cleavage ET subgroup, while in patients with worse prognosis only for P values ≥1.75 ng/mL. In the blastocyst ET subgroup, the negative effect of P elevation on was reported only if P was >1.75 ng/mL. CPR and LBR in thawed cycles resulted statistically significantly higher than in fresh cycles in the cleavage stage subgroup. In the blastocyst group, no significant difference resulted between thawed and fresh cycles, independently of P levels.
Conclusion: High P levels decrease CPR as well as LBR in both cleavage and blastocyst ET. In the cleavage group, for P levels below 1.75 ng/mL, it could be recommended to wait until day 5 for ET, and if P level is ≥1.75 ng/mL it should be considered to freeze all embryos and postpone the ET.