Association Between Post-Trigger Hormones and In Vitro Fertilization Cycle Outcomes

Numerous studies have evaluated the association between estradiol and progesterone levels on the day of trigger administration and cycle outcomes; however, less is known about serum hormone levels following trigger and whether they are associated with cycle outcomes. This study was conducted to assess the association between serum steroid hormone parameters on the day after oocyte maturation trigger and ovarian stimulation cycle outcomes.

This was a retrospective cohort study. All patients undergoing ovarian stimulation with the use of gonadotropins between September 2018 and September 2020 were assessed for inclusion. Chart review was performed to collect demographic information, cycle and trigger type, pre- and post-treatment serum hormone levels (estradiol, progesterone), and cycle outcomes. The primary outcomes were oocyte recovery rate, oocyte maturity rate, oocyte fertilization rate, and blastulation rate.

A total of 320 cycles were included in the study from 245 unique patients; 19% of cycles utilized a gonadotropin-releasing hormone (GnRH) agonist stimulation protocol and 81% utilized a GnRH antagonist stimulation protocol. Post-trigger progesterone level was associated with poor oocyte recovery, but not with oocyte maturity, fertilization, or blastulation rates. Post-trigger estradiol levels were not associated with oocyte recovery rate, oocyte maturity rate, fertilization rate, or blastulation rate.

This is one of few studies evaluating the association between estradiol and progesterone levels on the day after trigger injection and oocyte stimulation cycle outcomes. Our findings suggest that the association between post-trigger progesterone levels and poor oocyte recovery rate may be small but meaningful.