Is progesterone elevation on the day of human chorionic gonadotrophin administration associated with the probability of pregnancy in in vitro fertilization? A systematic review and meta-analysis.

Full Abstract

The role of progesterone elevation on in vitro fertilization (IVF) outcome has remained a debatable issue for several years. The aim of this systematic review and meta-analysis was to evaluate whether progesterone elevation on the day of human chorionic gonadotrophin (hCG) administration is associated with the probability of pregnancy. Eligible studies were considered those in which patients did not participate more than once. A literature search in MEDLINE, EMBASE and CENTRAL identified 12 eligible studies, 10 of which were retrospective. The majority (n = 10) of these studies did not detect a statistically significant association between progesterone elevation and the probability of pregnancy. Meta-analysis was performed only for the studies (n = 5) that provided data on clinical pregnancy per patient reaching hCG administration for final oocyte maturation. No statistically significant association between progesterone elevation and the probability of clinical pregnancy was detected (Odds ratio:
0.75, 95% confidence interval 0.53-1.06; P = 0.10). This finding persisted in the sensitivity analyses performed, which excluded the studies that did not report clearly that measurement of progesterone did not affect patients' management and those that did not report definition of clinical pregnancy. In addition, subgroup analyses were conducted on the basis of type of gonadotrophin-releasing hormone GnRH analogue used and on the value of serum threshold used to classify patients in those with or without progesterone elevation. These analyses, however, did not materially change the results obtained. In conclusion, the best available evidence does not support an association between progesterone elevation on the day of hCG administration and the probability of clinical pregnancy in women undergoing ovarian stimulation with GnRH analogues and gonadotrophins for IVF.

Learn Faster Today Improve your study skills

Author information

Author/s: Venetis, C A (CA); Kolibianakis, E M (EM); Papanikolaou, E (E); Bontis, J (J); Devroey, P (P); Tarlatzis, B C (BC);

Affiliation: Unit for Human Reproduction, 1st Department of Obstetrics and Gynaecology, Papageoriou General Hospital, Aristotle University of Thessaloniki, Nea Efkarpia, Peripheral Road, Thessaloniki, Greece.

Journal and publication information

Publication Type: Journal Article; Meta-Analysis; Review

Journal: Human reproduction update (Hum Reprod Update), published in England. (Language: eng)

Reference: -2007 Jul-Aug; vol 13 (issue 4) : pp 343-55

Dates: Created 2007/06/22; Completed 2007/08/17; Revised 2008/09/10;

PMID: 17405832, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Hum Reprod Update. 2008 Jul-Aug;14(4):391-2. (PMID: 18519555)

CommentIn: Hum Reprod Update. 2008 Jul-Aug;14(4):393. (PMID: 18522947)

CommentIn: Hum Reprod Update. 2008 Mar-Apr;14(2):194-5; author reply 195-6. (PMID: 18230603)

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Chorionic Gonadotropin - pharmacology
Female
Fertilization - drug effects
Fertilization in Vitro - drug effects
Follicle Stimulating Hormone - pharmacology
Humans

Associated Chemicals: Chorionic Gonadotropin (0) ; Progesterone (57-83-0) ; Follicle Stimulating Hormone (9002-68-0)

These are the highest related articles currently in the database:

See 100+ related articles.