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Mid-luteal progesterone concentrations are associated with live birth rates during ovulation induction
J-C Arce1, A Balen2, P Platteau3
1Ferring Pharmaceuticals A/S, Reproductive Health, Global Clinical and Non-Clinical R & D, Copenhagen, Denmark.
Reproductive Biomedicine Online
|March 15, 2011
Summary
Higher mid-luteal serum progesterone levels correlate with increased live birth rates in women with anovulatory infertility undergoing ovulation induction. This suggests progesterone concentration may indicate follicle and egg quality beyond simply confirming ovulation.
Area of Science:
- Reproductive Endocrinology
- Infertility Treatment
- Clinical Biochemistry
Background:
- Anovulatory infertility affects numerous women globally, necessitating effective ovulation induction protocols.
- Mid-luteal serum progesterone measurement is standard for confirming ovulation but its role in predicting live birth rates is less defined.
- Current diagnostic thresholds for ovulation may not fully capture the nuances of reproductive success.
Purpose of the Study:
- To investigate the association between mid-luteal serum progesterone concentrations and live birth rates in women with WHO Group II anovulatory infertility.
- To determine if progesterone levels above the established ovulation threshold correlate with improved pregnancy outcomes.
- To explore the relationship between follicular development, progesterone levels, and live birth rates.
Main Methods:
- Retrospective analysis of 335 women with WHO Group II anovulatory infertility undergoing gonadotropin stimulation.
- Inclusion criteria: presumptive ovulation defined as mid-luteal progesterone ≥7.9 ng/mL (n=279).
- Statistical analysis to correlate mid-luteal progesterone levels and follicle size with live birth rates.
Main Results:
- Women achieving live birth (20.4%) had significantly higher mid-luteal progesterone concentrations (P=0.016).
- Significant association found between the number of large and medium follicles and mid-luteal progesterone levels (P<0.001).
- Follicle number alone was not significantly associated with live birth rate, unlike progesterone concentration.
Conclusions:
- Mid-luteal progesterone concentrations exceeding current ovulation thresholds are positively associated with live birth rates in anovulatory women.
- Progesterone levels may serve as a biomarker for oocyte and corpus luteum quality, not just ovulation confirmation.
- Optimizing ovulation induction protocols may benefit from considering progesterone levels as a predictor of live birth success.
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