Premature luteinization during controlled ovarian hyperstimulation for in vitro fertilization-embryo transfer has no impact on pregnancy outcome

Objective: To determine if elevated serum P concentration on the day of hCG administration or P area under the curve (AUG) impacts on pregnancy rates (PRs) in IVF-ET cycles. Design: Retrospective study. Patient(s): One hundred thirty-three couples underwent IVF-ET using luteal GnRH-agonist suppression followed by hyperstimulation with gonadotropins. Patient cycles were controlled for female age, ovarian reserve, male factor with intracytoplasmic sperm injection (ICSI), endometrial thickness and pattern, number of embryos, and number of high-quality embryos transferred, and cell stage at transfer. Pregnancy was defined as an ongoing pregnancy > 20 weeks. Result(s): Patients and cycle parameters did not differ significantly based on the control parameters. Similar numbers of severe male factors treated by ICSI were in each group with similar PRs. Pregnancy fates and implantation rates did not differ based on P levels less than or equal to 0.9, less than or equal to 1.1, and less than or equal to 1.4 ng/mL (conversion factor to SI unit, 3.18). Serum P concentrations per total eggs retrieved or per mature egg retrieved did not influence pregnancy outcome. Efficiency curves for serum P levels and P AUC did not demonstrate any differences in PR. At very high serum P (P > 2.0 ng/mL) sample size limits the ability of these data to rule out a negative effect. Conclusion(s): Serum P levels (and P AUC) commonly encountered during cycles of IVF-ET have no impact on pregnancy outcome.