Progesterone response to exogenous gonadotropins after suppression with leuprolide acetate in gamete intrafallopian...

Fifty-three cycle of ovarian stimulation with human menopausal gonadotropins after suppression of endogenous gonadotropin release with leuprolide acetate were completed for the purpose of performing gamete intrafallopian transfer. Thirty-seven biochemical pregnancies resulted, with 29 progressing to clinical status, for rates of 69.8% and 54.7%, respectively, per cycle. In comparing characteristics of the follicular recruitment phases of failed cycles to those of cycles resulting in pregnancies, no differences were observed in serum estradiol concentrations or follicular development. However, pregnancy rates were highly associated with peak concentrations of progesterone prior to the administration of human chorionic gonadotropin. Three levels of progesterone range were found on the basis of outcome: 6 high-progesterone cycles produced no pregnancies (0%), 32 mid-range progesterone cycles produced 31 pregnancies (97%), and 15 low-progesterone cycles produced six pregnancies (40%). The pregnancy rate in the last group improved when the luteal support was doubled.