Mid-Luteal 17-OH Progesterone Levels in 614 Women Undergoing IVF-Treatment and Fresh Embryo Transfer-Daytime Variation and Impact on Live Birth Rates.

Corpus luteum (CL) produces progesterone (P) and 17-OH progesterone (17-OH P) during the luteal phase. Contrary to P, 17-OH P is not supplied as part of the luteal phase support following IVF-treatment. Therefore, measuring endogenous serum 17-OH P levels may more accurately reflect the CL function compared to monitoring serum P concentrations. To explore the correlation between mid-luteal serum 17-OH P levels and live birth rates and to explore the possible daytime variations in mid-luteal serum 17-OH P Prospective cohort study. 614 women undergoing IVF-treatment and fresh embryo transfer. All patients had serum 17-OH P measured 7 days after oocyte pick-up (OPU+7). Furthermore, on OPU+7, seven patients underwent repeated blood sampling during daytime to clarify the endogenous daytime secretory pattern of 17-OH P. Live birth rate. Daytime variation in serum 17-OH P levels. The highest chance of a live birth was seen with mid-luteal 17-OH P between 6.0 and 14.0 nmol/l. The chance of a live birth was reduced below (RD -10%, = 0.07), but also above the optimal range for 17-OH P (RD -12%, = 0.04). Patients with diminished CL-function (17-OH P < 6 nmol/l) displayed clinically stable 17-OH P values, whereas patients with 17-OH P levels >6 nmol/l showed random 17-OH P fluctuations during daytime. The association between 17-OH P and reproductive outcomes is non-linear, and the negative effect of excessive CL-secretion seems to be just as strong as the negative effect of a reduced CL-function during the peri-implantation period.