Pre-Mature Raise of Progesterone and its Effect on Clinical Pregnancy Rate and Live Birth Rate in Intra-Cytoplasmic Sperm Injection (ICSI) Cycles

Abstract

Background: During controlled ovarian hyper-stimulation COH, level of Progesterone on a day of human chorionic gonadotrophin (hCG) trigger for a final ovum maturation has a precious role for implantation of the embryos. Aims: This study aims to investigate the incidence and the effect of Premature Progesteron Rise (PPR) on pregnancy rates PR as well as live birth rate LBR in ICSI cycle. Material and Methods: A total of 710 patients undergoing ICSI cycles with fresh embryo transfer at Misurata National Infertility Centre were retrospectively involved. Patients included in the study who are <40 years with good ovarian response and had long agonist/antagonist ICSI protocols with fresh embryo transfer. Results: The average age of patients was (32.26 years ± 4.924). The cut-off value found in this study to define PPR is (1.064 ng/ml). The overall incidence of serum PPR on hCG administration was 31.32%. The average serum PPR on a day of hCG administration was (1.1 ±1.8) ng/ml. PPR had a negative significant effect on PR (P-value 0.03). Conclusion: In order to improve ICSI outcome, the PR is significantly negatively correlated with PPR. So, when serum P4 level is approaching the cutoff value (1.064 ng/ml) during COH, modification of the clinical treatment might be considered to improve the ICSI outcomes.