Progesterone level at oocyte retrieval predicts in vitro fertilization success in a short-antagonist protocol: a prospective cohort study

ObjectiveTo evaluate the distribution of P levels on the day of oocyte retrieval as it relates to pregnancy outcome in an antagonist protocol, which may be at higher risk for elevated P levels.DesignProspective cohort study.SettingAcademic IVF center.Patient(s)One hundred eighty-six women undergoing controlled ovarian hyperstimulation with an antagonist protocol.Intervention(s)None.Main Outcome Measure(s)Implantation, pregnancy, and spontaneous abortion rates were collected.Result(s)Implantation rate (positive hCG 14 days after ET) and pregnancy rate were significantly higher when the P level was <12 ng/mL on the day of oocyte retrieval. Miscarriage rates were higher when the P level was ≥12 ng/mL, although this did not reach statistical significance.Conclusion(s)Elevated P on the day of oocyte retrieval is associated with significantly lower implantation and ongoing pregnancy rates. This is the first study to date to both uncover the distribution of P on the day of oocyte retrieval in an antagonist cycle and determine the impact an elevation may have on pregnancy outcome.