Effect of premature luteinizing hormone rise on pregnancy outcomes in patients with high trigger day progesterone levels in GnRH antagonist in vitro fertilization cycles

Abstract

Objective: The purpose of this retrospective cohort study was to investigate how a premature rise in serum luteinizing hormone (LH) level affects pregnancy outcomes in patients with high progesterone (P) levels (≥1.5 ng/mL) on ovulation trigger day in GnRH antagonist/intracytoplasmic sperm injection cycles (ICSI). Materials and Methods: Between March 2010-July 2015, a total of 2.111 GnRH antagonist/ICSI cycles were conducted at Tepecik Education and Research Hospital, Gynecology and Obstetrics Clinic, In Vitro Fertilization Center. Serum LH levels were monitored during follicular phase and serum P levels were measured on the hCG-day. Basic demographic, hormonal and developmental data of embryos following oocyte retrieval and pregnancy outcome of patients were also monitored. Among all, 205 cycles matching inclusion criteria and with serum P levels .1.5 ng/mL on hCG day were included in the analysis. Results: Mean age (31.2±4.5 vs. 33.0±4.8, year) and body mass index (24.6±4,4 vs. 26.2±3.6, kg/m2), infertility reasons and baseline hormonal levels are similar in the normal vs. high LH level groups. Premature LH rise (>10 mIU/mL) was detected in 9 (4.39%) of the 205 antagonist cycles with high serum P levels (>1.5 ng/mL) on ovulation trigger day. The group with the premature LH rise had higher chemical, clinical, ongoing pregnancy and live birth rates (44.4% for all) than the group without premature LH rise (30.6%, 23.5%, 17.9% and 17.9%, respectively). However, the differences were not significant (p values were equal to 0.465, 0.226, 0.069 and 0.069 respectively). Additionally, logistic regression analysis did not find a statistically significant difference between the two groups in terms of all pregnancy rates. Conclusion: In conclusion, in GnRH antagonist/ICSI cycles with hCG-day serum P levels .1.5 ng/mL, there was no statistically significant difference between chemical, clinical, ongoing pregnancy and live birth rates among the groups with and without premature LH rise.