Relationship between Circulating Human Chorionic Gonadotropin Levels and Premature Progesterone Elevation in Cycles of Controlled Ovarian Hyperstimulation

Oh, M J; Kim, S H; Koo, B S

Abstract

To determine whether premature progesterone elevation on or before the day of hCG administration during controlled ovarian hyperstimulation (COH) is associated with elevated levels of serum beta-hCG, we reviewed the 70 cycles of oocyte retrieval for IVF after COH with GnRH agonist and hMG from October 1996 to July 1997. Serum estradiol, progesterone, LH, and beta-hCG were determined using radioimmunoassay (RIA) on the day of hCG administration. Additionally, we analyzed pregnancy outcomes related to the serum progesterone levels. The results were as follows: 1. The magnitude of the progesterone elevation was significantly related to the number of oocytes retrieved (r=0.636, p<0.05) and serum estradiol levels (r=0.691, p<0.001). 2. Serum progesterone and progesterone/No. of oocytes retrieved did not correlate with LH levels. 3. Serum progesterone levels were not correlate with the serum beta-hCG level, on the other hand serum progesterone levels/No. of oocytes retrieved were correlated with the hCG levels (p<0.05). 4. Ampules of hMG did not correlate with the serum beta-hCG. 5. Pregnancy outcomes indicated poorer pregnancy outcomes were obtained with oocytes originated from IVF-ET cycles with elevated progesterone/No. of oocytes retrieved without statistically significant differences. In conclusion, it is reasonable to hypothesize that the cause of the premature elevation of progesterone is associated closely to the elevated serum beta-hCG levels. And the magnitude of the serum progesterone elevation is related to the number of mature follicles, therefore it might be reasonable to change the concept of premature luteinization with the elevation of pregesterone/No. of oocyte retrieved.