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Original Research
Outcome and recurrence risk of premature progesterone rise in IVF/ICSI cycles using GnRH antagonists for pituitary down-regulation
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1
2nd Department, Aretaieion Hospital, University of Athens, Athens, Greece
2
3rd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Athens, Greece
Clin. Exp. Obstet. Gynecol. 2018, 45(1), 44–47;
https://doi.org/10.12891/ceog3704.2018
Published: 10 February 2018
Abstract
Summary: To assess the outcome and recurrence risk of premature progesterone rise (PPRR) in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles using gonadotropin-releasing hormone (GnRH) antagonists. Materials and Methods: Two hundred and two patients undergoing IVF/ICSI using GnRH antagonists for pituitary down-regulation had measurements of luteinizing hormone (LH), progesterone (P), and estradiol (E2) on specific days of the first and subsequent stimulation cycle. Results: The overall clinical pregnancy rate including the total of 280 cycles was 29.3% (82/280). The incidence of PPRR on the day of triggering for P ≥ 1.5 ng/ml its was 20.8% (42/202). The risk of PPRR ≥ 1.5 ng/ml on the triggering day of the subsequent cycle was 40% if the previous cycle P was ≥ 1.5 ng/ml, 13.3% if the previous cycle P was ≥ 1.2 ng/ml and < 1.5 ng/ml, and 10% if the previous cycle P was < 1.2 ng/ml. Conclusion: The presence of PPRR in IVF/ICSI cycles using GnRH antagonists affects negatively the pregnancy rates and poses a significant risk of recurrence in a subsequent cycle.
Keywords
GnRH antagonist
Ganirelix
Ovarian stimulation
Premature progesterone
IVF
ICSI