Elevated serum progesterone level on the day of human chorionic gonadotropin administration does not adversely affect implantation rates after intracytoplasmic sperm injection and embryo transfer

Objective: To evaluate the association between serum P levels on the day of hCG administration and the outcome of intracytoplasmic sperm injection (ICSI). Design: Retrospective case study. Setting: Assisted reproduction unit of a tertiary care private hospital. Patient(s): Nine hundred eleven ICSI cycles that proceeded to ET were studied. Intervention(s): The decision to administer hCG was based on serum E-2 levels and follicle size. Serum P was measured from frozen sera obtained on the day of hCG administration. Cycles were stratified according to serum P levels of <0.9 ng/mL (n = 298) or greater than or equal to 0.9 ng/mL (n = 613). This cutoff level was selected because it yielded the highest sensitivity and specificity according to a receiver operator characteristic curve. Main Outcome Measure(s): Implantation and clinical pregnancy rates. Result(s): In cycles with high serum P levels, more oocytes were retrieved and more embryos were available for transfer. Clinical pregnancy rates per ET in the low and high P groups were 36.9% and 45.4%, respectively (P<.05). The implantation rate per embryo was similar in the two groups (14.9% and 16.4%, respectively, in cycles with P levels <0.9 vs greater than or equal to 0.9 ng/mL). Abortion rates were 22.7 and 25.8%, respectively (P>.05). Conclusion(s): Our data showed no adverse effect of high serum P levels on the day of hCG administration on implantation rates after ICSI and ET. ((C)1999 by American Society for Reproductive Medicine.).