Midluteal Serum Estrogen and Progesterone Levels predict Pregnancy Rate in in vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Prospective Study

Abstract

Introduction: In assisted reproduction technique cycles, controlled ovarian stimulation (COS) leads to supraphysiological levels of steroid hormone secretion and the subsequent need for luteal phase support (LPS). Therefore, existing data on the steroid secretion profile in the luteal phase of spontaneous conception cycles and its predictive value for pregnancy outcome need to be discussed against the background of preceding COS. The clinical significance of luteal phase hormones, such as estrogen (E2) and progesterone (P4), in predicting pregnancy after controlled ovarian hyperstimulation protocols for in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is still poorly understood. The aim of the present study was to investigate the role of midluteal serum E2 and P4 level in predicting successful pregnancy in patients undergoing IVF/ICSI. Materials and methods: One hundred fifteen women were recruited for the study. They were given gonadotropin-releasing hormone antagonist protocol and human chorionic gonadotropin (hCG) was administered if at least three follicles were more than 18 mm in size. Transvaginal ultrasound-guided oocyte retrieval followed by ICSI and embryo transfer (ET) was done. Post-ET, all women had same LPS. The E2 and P4 measurements were done at day of ET (day 0) and 9 days post-ET (day 9). Levels of E2 and P4 were compared between those who subsequently became pregnant and those who could not achieve pregnancy. Statistical analysis was performed using Statistical Package for the Social Sciences. Results: Forty-six (40%) achieved pregnancy. The E2 and P4 levels on day 9 were significantly higher in those who achieved pregnancy (p < 0.01). Out of 46 pregnancies, 38 were ongoing viable pregnancies. Conclusion: Luteal phase E2 and P4 can be used as prognostic marker to predict pregnancy in IVF/ICSI cycles.