Evaluation of the role of serum progesterone level on the day of human chorionic gonadotropin administration on intracytoplasmic sperm injection outcome

According to some literature on the importance of progesterone on prognosis of controlled ovarian hyperstimulation outcome, the present study was designed to evaluate the role of elevated serum progesterone level on the day of hCG administration on ICSI results. In the present descriptive study, 224 patients undergoing ICSI with GnRH agonist were analyzed. These patients were divided into 2 groups based on serum progesterone level on the day of hCG administration: progesterone <1 ng/ml (group 1, n=180), progesterone ≥1 ng/ml (group 2, n=44). Baseline and stimulation characteristics of patients were compared between groups. The mean age, BMI, basal LH, FSH and E2 levels did not differ between two groups. Estradiol level on the day of hCG (1951.5±800.7 vs. 1232±734.6, P<0.001) and number of retrieved (14.6±7.6 vs. 9.9±6, P<0.001) and MII oocytes (11.8±5.9 vs. 8.1±5.3, P<0.001) were significantly higher in group 2 than group 1. The stimulation days (12.9±1.8 vs. 13±1.8, P=0.767), total number of gonadotropin ampoules (40.6±16 vs. 43.6±12.9, P=0.236), fertilization rate (59.7% vs. 54.1%, p=0.068) and mean number of embryos transferred (2.8±0.8 vs. 3±0.6, P=0.086) were not significantly different between groups. No significant decrease in implantation (14.3% vs. 20.2%, P=0.128) and clinical pregnancy rate (29.5% vs. 45%, P=0.063) was identified in group 2 as compared with group 1. It seems that elevated serum progesterone level on the day of hCG administration is effective on prognosis of ICSI outcome.