EVALUATION OF THE REPRODUCTIVE-PERFORMANCE OF WOMEN WITH ELEVATED DAY-10 PROGESTERONE LEVELS DURING OVARIAN RESERVE SCREENING

Objectives: To evaluate the relationship of elevated day 10 P levels (greater than or equal to 1.1 ng/mL, conversion factor to SI unit, 3.18) during ovarian reserve screening and reproductive performance. Design: Prospective screening with longitudinal follow-up. Interventions: One hundred seven women underwent ovarian reserve screening with a clomiphene citrate challenge test. Main Outcome Measures: Serum FSH, LH, and E(2) levels were determined on cycle day 3 and FSH, LH, and P levels were determined on day Ib. A fertility evaluation was completed and a treatment plan was instituted. Results: Twenty-two of 107 (20.6%) women had day 10 P levels greater than or equal to 1.1 ng/mL. Women with elevated day 10 P levels were similar in age to women with normal day 10 P levels (less than or equal to 0.9 ng/ mt) but had significantly shorter menstrual cycles, higher day 3 and day 10 FSH levels, higher day 3 E(2) levels, and higher day 10 LH levels than women with normal day 10 P levels. During ovarian hyperstimulation, women with elevated day 10 P levels required more ampules of hMG, had lower peak E(2) levels, and had fewer mature follicles than women with a normal day 10 P level. Sixteen of 85 (18.8%) women with normal day 10 P levels became pregnant, but none of the 22 women with elevated day 10 P levels became pregnant. The incidence of diminished ovarian reserve was higher in women with elevated day 10 P levels (13/22; 59%) when compared with women with a normal day 10 P levels (9/85; 10.6%). Conclusions: Elevated day 10 P levels (greater than or equal to 1.1 ng/mL) during ovarian reserve screening is associated with diminished ovarian reserve and correlates with menstrual cycle parameters associated with a short follicular phase and poor reproductive performance.