Xu Yueming, Zhang Jie, Li Aimin, Yang Ni, Cui Na, Hao Guimin, Gao Bu-Lang
Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Front Cell Dev Biol. 2022 Mar 11;10:855455. doi: 10.3389/fcell.2022.855455. eCollection 2022.
To investigate the effect of progesterone elevation during late follicular phase on early pregnancy outcomes and live births after fresh embryo transfers. Patients who underwent IVF/ICSI treatment cycles were retrospectively enrolled. The effect of progesterone elevation was analyzed on early pregnancy outcome and live births after fresh embryo transfers. A total of 2,404 patients were enrolled on the day of HCG triggering (HCG0), 1,584 patients on the day before HCG triggering (HCG-1), and 800 patients 2 days before HCG triggering (HCG-2). With a 1 ng/ml increase in the progesterone level on HCG0 day when the progesterone level was ≥1.5 ng/ml, the clinical pregnancy rate decreased by 60% (95% CI: 0.2-0.7, = 0.004), the intrauterine pregnancy rate decreased by 70% (95% CI: 0.2-0.7, = 0.003), and the live birth rate decreased by 70% (95% CI: 0.1-0.7, = 0.004). With a 1 ng/ml increase in the progesterone level on HCG-1 day, the clinical pregnancy rate decreased by 90% (95% CI: 0.0-0.5, = 0.003) when the progesterone level was ≥1.6 ng/ml, the intrauterine pregnancy rate decreased by 90% (95% CI: 0.0-0.5, = 0.001) when the progesterone was ≥1.5 ng/ml, and the live birth rate decreased by 90% (95% CI: 0.0-0.6, = 0.015) when the progesterone was ≥1.7 ng/ml. On HCG-2 day when the progesterone was ≥1.2 ng/ml, the clinical pregnancy rate decreased by 80% (95% CI: 0.1-0.6, = 0.003), and the intrauterine pregnancy rate decreased by 70% (95% CI: 0.1-0.7, = 0.007) with a 1 ng/ml increase in the progesterone level. Elevated progesterone level during the late follicular phase is an independent risk factor affecting the clinical pregnancy rate, intrauterine pregnancy rate, and live birth rate among infertile patients undergoing IVF/ICSI after fresh embryo transfers. When the progesterone level exceeds a certain level, the early pregnancy and live birth rates after fresh embryo transfers show a rapid downward trend.
探讨卵泡晚期孕酮升高对新鲜胚胎移植后早期妊娠结局及活产的影响。回顾性纳入接受体外受精/卵胞浆内单精子注射（IVF/ICSI）治疗周期的患者。分析孕酮升高对新鲜胚胎移植后早期妊娠结局及活产的影响。共有2404例患者在人绒毛膜促性腺激素（HCG）注射日（HCG0）入组，1584例患者在HCG注射日前一天（HCG-1）入组，800例患者在HCG注射日前两天（HCG-2）入组。当HCG0日孕酮水平≥1.5 ng/ml且孕酮水平每升高1 ng/ml时，临床妊娠率下降60%（95%可信区间：0.2 - 0.7，P = 0.004），宫内妊娠率下降70%（95%可信区间：0.2 - 0.7，P = 0.003），活产率下降70%（95%可信区间：0.1 - 0.7，P = 0.004）。当HCG-1日孕酮水平≥1.6 ng/ml且孕酮水平每升高1 ng/ml时，临床妊娠率下降90%（95%可信区间：0.0 - 0.5，P = 0.003）；当孕酮≥1.5 ng/ml时，宫内妊娠率下降90%（95%可信区间：0.0 - 0.5，P = 0.001）；当孕酮≥1.7 ng/ml时，活产率下降90%（95%可信区间：0.0 - 0.6，P = 0.015）。在HCG-2日，当孕酮≥1.2 ng/ml且孕酮水平每升高1 ng/ml时，临床妊娠率下降80%（95%可信区间：0.1 - 0.6，P = 0.003），宫内妊娠率下降70%（95%可信区间：0.1 -
