Progesterone/Oestradiol ratio can Better Predict Intracytoplasmic Sperm Injection Outcomes than Absolute Progesterone...

Area of Science:

• Reproductive endocrinology and infertility research.
• In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes analysis.

Background:

• Premature luteinization in intracytoplasmic sperm injection (ICSI) cycles can impact outcomes.
• Parameters like progesterone (P) level, P to oocyte ratio, and P/estradiol (P/E2) ratio have been explored for prediction.

Purpose of the Study:

• To compare the predictive value of the P/E2 ratio versus isolated P level on ovulation triggering day for pregnancy outcomes.
• To evaluate these markers in fresh GnRH antagonist ICSI cycles.

Main Methods:

• Retrospective cohort study of 402 women undergoing GnRH antagonist ICSI cycles with day-3 embryo transfer.
• Calculation of P/E2 ratio and categorization based on established cutoff values for high P (HP) and high P/E2 ratio.
• Multivariate regression analysis and receiver operating curve (ROC) analysis to assess predictive capabilities for ongoing pregnancy.

Main Results:

• The P/E2 ratio demonstrated a significant association with ongoing pregnancy (adjusted odds ratio [aOR]: 0.409, P=0.004).
• Isolated high progesterone (HP) levels did not show a significant predictive value for ongoing pregnancy (aOR: 0.542, P=0.064).
• The area under the curve for P/E2 was 0.67, compared to 0.59 for P alone.

Conclusions:

• Progesterone elevation alone may not be a reliable independent predictor of ICSI cycle outcomes.
• The P/E2 ratio offers superior prognostic value compared to isolated P levels for predicting pregnancy in GnRH antagonist ICSI cycles.