The Effect of Progesterone Concentration on Live Birth Rate in Fresh Blastocyst Transfer

Abstract

Objective: This study sought to determine how the concentration of progesterone on the trigger day of fresh embryo transfer cycles affected the live birth rate. Materials and Method: Re-analysis of a multicenter randomized trial was used in this study (ChiCTR-IOR-14005405). In the investigation, fresh single blastocyst transfers utilizing the gonadotropin-releasing hormone (GnRH) antagonist procedure were performed on normal ovarian response of 536 women and with a high ovarian response of 200. Live birth was the main result. Results: There is greater levels of progesterone on the human chorionic gonadotropin (hCG) of women with a high ovarian response trigger day than women with a normal ovarian response (1.31 ± 0.56 and 1.07 ± 0.45 ng/mL, respectively; p < 0.001). With the decrease of live birth rate when the progesterone levels were ≥1.5 ng/mL in women with a high ovarian response this was not seen in women who had a normal ovarian response (p = 0.141); The difference was (p = 0.039). The high ovarian response in women, but not in those with a normal ovarian response (p = 0.293), the logistic regression analysis of multivariate showed that the level of progesterone on the hCG trigger day correlated negatively with the live birth rate (odds ratio: 0.48, 95% confidence interval: 0.23–0.99, p = 0.046). On the hCG trigger day, the progesterone cut-off point for women with a high ovarian response was 1.54 ng/mL (p = 0.041), according to the receiver operating characteristic (ROC) curve analysis. Conclusions: Employing the GnRH antagonist on the embryo transfer cycles, increased the levels of progesterone on the hCG trigger day that may impact live birth rates negatively.