Subtle progesterone rise on the day of human chorionic gonadotropin administration is associated with lower live birth rates in women undergoing assisted reproductive technology: a retrospective study with 2,555 fresh embryo transfers

ObjectiveTo evaluate the association between serum P levels on the day of hCG administration and pregnancy outcome in women undergoing controlled ovarian hyperstimulation, prevention of premature ovulation by GnRH analogues, and fresh ET after 5 days of embryo culture.DesignRetrospective, observational, cohort study.SettingPrivate IVF center.Patient(s)A total of 2,555 women undergoing fresh ET on day 5 in 2,062 GnRH agonist and 493 GnRH antagonist cycles.Intervention(s)None.Main Outcome Measure(s)Live birth rate.Result(s)Live birth rate in cycles with GnRH agonists was significantly lower in women with P levels ≥2.0 ng/mL (17.4%) on the day of hCG administration as compared with women with P levels <1.5 ng/mL (24.6%) and 1.5–1.99 ng/mL (26.7%). No such significant differences in live birth rates in cycles with GnRH antagonist could be observed.Conclusion(s)A rise of serum P levels ≥2.0 ng/mL on the day of hCG administration is associated with impaired early embryo implantation and reduced live birth rate in cycles with GnRH agonists after day-5 fresh ET.Clinical Trial Registration NumberNCT01426152.