Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Endocrinol (Lausanne). 2023 Apr 19;14:1162302. doi: 10.3389/fendo.2023.1162302. eCollection 2023.
Numerous research have investigated the predictor role of progesterone (P) level on the human Chorionic Gonadotropin (hCG) trigger day of assisted reproductive technology (ART) outcomes. However, the relationship of progesterone levels on hCG day to clinical pregnancy outcomes in IVF/ICSI cycles for patients with different BMI groups is still elusive. This study aimed to investigate the effects of progesterone elevation on triggering day on clinical pregnancy rate (CPR) of IVF/ICSI cycles in patients with different female BMI.
We conducted a retrospective cohort study included 6982 normal-weight parents (18.5Kg/m2≤BMI<25Kg/m2) and 2628 overweight/obese patients (BMI≥25Kg/m2) who underwent fresh day 3 cleavage embryo transfer (ET) in IVF/ICSI cycles utilizing GnRH agonist to control ovarian stimulation.
The interaction between BMI and P level on triggering day on CPRs was significant (<0.001). The average level of serum P was reduced with the increase in maternal BMI. Serum P adversely affected CPR in distinct BMI groups. In the normal weight group, CPRs were decreasedas serum P concentrations gradually increased (<0.001 for overall trend). The CPRs (lower than 65.8%) of progesterone level > 1.00 ng/ml on triggering day were significantly lower than that (72.4%) of progesterone level <0.5 ng/ml. In the overweight/obese group, CPRs showed a decrease statistically with progesterone levels of ≥2.00 ng/ml compared to progesterone levels of <0.5 ng/ml (51.0% VS. 64.9%, =0.016). After adjusting for confounders, progesterone elevation (PE) negatively correlated with CPRs only in the normal weight group (OR: 0.755 [0.677-0.841], <0.001), not in the overweight/obese group (=0.063).
Women with higher BMI exhibited a lower progesterone level on triggering day. Additionally, PE on hCG day is related to decreased CPRs in GnRH agonist IVF/ICSI cycles with cleavage embryo transfers regardless of women's BMI level (normal weight VS. overweight/obesity).
许多研究已经探讨了孕激素（P）水平对辅助生殖技术（ART）结局人绒毛膜促性腺激素（hCG）触发日的预测作用。然而，对于不同 BMI 组的患者，hCG 日孕激素水平与临床妊娠结局的关系仍不清楚。本研究旨在探讨不同 BMI 组患者 IVF/ICSI 周期中 hCG 日孕激素升高对触发日临床妊娠率（CPR）的影响。
我们进行了一项回顾性队列研究，纳入了 6982 名正常体重的父母（18.5kg/m2≤BMI<25kg/m2）和 2628 名超重/肥胖患者（BMI≥25kg/m2），他们在 IVF/ICSI 周期中使用 GnRH 激动剂控制卵巢刺激，进行新鲜的第 3 天卵裂胚胎移植（ET）。
BMI 和触发日 P 水平对 CPR 的交互作用有统计学意义（<0.001）。随着母体 BMI 的增加，血清 P 的平均水平降低。血清 P 在不同的 BMI 组中对 CPR 有不利影响。在正常体重组中，随着血清 P 浓度逐渐升高，CPR 下降（整体趋势<0.001）。触发日 P 水平>1.00ng/ml 的 CPRs（低于 65.8%）明显低于 P 水平<0.5ng/ml 的 CPRs（72.4%）。在超重/肥胖组中，与 P 水平<0.5ng/ml 相比，P 水平≥2.00ng/ml 的 CPRs 呈统计学下降（51.0%比 64.9%，=0.016）。调整混杂因素后，只有在正常体重组中，孕激素升高（PE）与 CPRs 呈负相关（OR：0.755[0.677-0.841]，<0.001），而在超重/肥胖组中则无相关性（=0.063）。
BMI 较高的女性在触发日时孕激素水平较低。此外，在 GnRH 激动剂 IVF/ICSI 周期中，无论女性 BMI 水平如何（正常体重与超重/肥胖），hCG 日的 PE 与 CPR 下降有关。
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