The efficiency of progesterone/estradiol and progesterone/follicle ratio without elevated trigger-day progesterone levels on the reproductive outcomes of GnRH antagonist IVF/ICSI cycles.

AIM

To assess the predictive value of serum progesterone/estradiol (P/E) and serum progesterone/follicle (P/F) ratios on the reproductive outcomes of women without elevated trigger-day progesterone levels undergoing GnRH-antagonist IVF ( fertilization)/ICSI (intracytoplasmic sperm injection) cycles.

MATERIALS AND METHODS

This was a retrospective cohort study in a university teaching hospital conducted between January 2017 and December 2019. Couples who underwent assisted reproduction cycles were evaluated. Initially, 978 cycles were evaluated and only GnRH antagonist cycles ( = 505) without elevated trigger-day progesterone levels were analyzed after respecting exclusion criteria.

RESULTS

A total of 505 cycles were analyzed after the exclusion criteria were met. The clinical pregnancy rate, ongoing pregnancy rate, and live birth rate were 45.5%, 30.9%, and 27.8%, respectively. Cutoff values of P/E and P/F ratios that were discriminative for achieving or not achieving clinical pregnancy were 0.36 and 0.17, respectively. The clinical pregnancy rates were found to be significantly different between below and above P/E cutoff values (49.8% vs. 40.1%, respectively,  = .031), while there were no significant differences between below and above P/F cutoff values regarding the pregnancy outcomes.

CONCLUSION

The P/E and P/F ratios were found to be more efficient and reliable markers than serum progesterone level alone in predicting the reproductive outcomes of assisted reproduction cycles without a premature rise in serum progesterone levels. A P/E ratio ≤0.36 and a P/F ratio ≤0.17 significantly improved the cycle outcomes.