The effect of hCG day progesterone in 1318 cycles on pregnancy outcomes: ongoing discussion

To investigate the effect of human chorionic gonadotropin day progesterone (hCG-P) level on pregnancy outcomes in in vitro fertilization (IVF) cycles.

This study is an analysis of a cohort of 1318 fresh IVF- embryo transfer cycles, including 579 agonists and 739 antagonists, performed at a single IVF center between 2007 and 2018. For fresh cycles, we performed Receiver Operating Characteristic analysis (ROC) to calculate the threshold value of hCG-P, which affects pregnancy outcomes. We divided patients below and above the determined threshold value into two groups, then, correlation analysis and we performed logistic regression analysis.

According to ROC curve analysis of hCG-P, AUC was 0.537 (95% CI: 0.510-0.564, p < 0.05) for LBR, and the threshold value for P was 0.78. The hCG-P threshold value of 0.78 proved to be significant in relation to BMI, type of drug used during induction, the hCG day E2, the total number of oocytes, the number of oocytes and the subsequent pregnancy outcome between the two groups (p < 0.05). However, the model we built, which accounted for hCG-P, total number of oocytes, age, BMI, induction protocol, total dose of gonadotropin used in induction did not prove significant in terms of its effect on LBR.

The threshold value of hCG-P that we found to have an effect on LBR was quite low compared with the p value generally recommended in the literature. Therefore, further studies are needed to determine an accurate p-value that reduces success in managing fresh cycles.