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Influence of the Postovulatory Progesterone on the Outcome of In Vitro Fertilization
Emina Ejubovic1, Miro Kasum2, Emir Mahmutbegovic3
1Department of Gynaecology, Obstetrics and Reproductive Endocrinology, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, BIH.
Aim:
To investigate the influence of postovulatory progesterone (P4) on the outcome of in vitro fertilization (IVF).
Materials And Methods:
This was a prospective cohort study which included 400 patients (300 in the control group and 100 in the group with elevated preovulatory P4 (preovulatory P4 > 4.77 nmol/L) - 85 normal responders and 15 high responders). The influence of postovulatory P4 on the IVF outcome has been investigated in this study.
Results:
It was found that the P4 value on the fifth cycle day at a concentration ≤425.7 nmol/L has a high sensitivity (86.21%, 95% CI 81.7-90.0%) and a low specificity (23.64%, 95% CI 16.1-32.7%) in all patients in the study. The obtained results showed that P4 values on day 5 >425,7 nmol/L in all patients, and the P4 on the 5th day >384,6 nmol/L among patients with elevated preovulatory P4 represent a threshold for the successful IVF procedure (positive ultrasound visualization of the gestational sac at six weeks of pregnancy with the presence of fetal heart action after embryo transfer).
Conclusion:
The P4 on the fifth day >425,7 nmol/L could be a potential marker for the success of the IVF procedures among all the patients, and with P4 on the fifth day >384,6 nmol/L among patients with elevated preovulatory P4.
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