Fertility and sterility · 2016
Is the effect of premature elevated progesterone augmented by human chorionic gonadotropin versus gonadotropin-releasing hormone agonist trigger?
СтатьяResearch Support, N.I.H., IntramuralНазвание и аннотация: Перевод в очереди
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Connell Matthew T, Patounakis George, Healy Mae Wu, DeCherney Alan H, Devine Kate, Widra Eric, Levy Michael J, Hill Micah J
Аннотация
OBJECTIVE: To compare the effect of P on live birth rate between hCG and GnRH agonist (GnRH-a) trigger cycles.
DESIGN: Retrospective cohort study.
SETTING: Large private assisted reproductive technology (ART) practice.
PATIENT(S): A total of 3,326 fresh autologous ART cycles.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Live birth.
RESULT(S): A total of 647 GnRH-a trigger cycles were compared with 2,679 hCG trigger cycles. Live birth was negatively associated with P in both the hCG trigger (odds ratio [OR] 0.62, 95% confidence interval [CI] 0.52-0.76) and the agonist trigger cohorts (OR 0.56, 95% CI 0.45-0.69). Interaction testing evaluating P and trigger medication was not significant, indicating that P had a similar negative effect on live birth rates in both cohorts. Progesterone ≥2 ng/mL occurred more commonly in GnRH-a trigger cycles compared with hCG trigger cycles (5.5% vs. 3.1%) and was negatively associated with live birth in both the hCG trigger (OR 0.28, 95% CI 0.11-0.73) and agonist trigger cohorts (OR 0.35, 95% CI 0.14-0.90). When P ≥2 ng/mL, the live birth rates were poor and similar in the hCG and GnRH-a cohorts (5.9% vs. 14.2%), indicating that P ≥2 ng/mL had a similar negative effect on live birth in both cohorts.
CONCLUSION(S): Elevated serum P on the day of hCG was negatively associated with live birth rates in both hCG and GnRH-a trigger cycles.
DESIGN: Retrospective cohort study.
SETTING: Large private assisted reproductive technology (ART) practice.
PATIENT(S): A total of 3,326 fresh autologous ART cycles.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Live birth.
RESULT(S): A total of 647 GnRH-a trigger cycles were compared with 2,679 hCG trigger cycles. Live birth was negatively associated with P in both the hCG trigger (odds ratio [OR] 0.62, 95% confidence interval [CI] 0.52-0.76) and the agonist trigger cohorts (OR 0.56, 95% CI 0.45-0.69). Interaction testing evaluating P and trigger medication was not significant, indicating that P had a similar negative effect on live birth rates in both cohorts. Progesterone ≥2 ng/mL occurred more commonly in GnRH-a trigger cycles compared with hCG trigger cycles (5.5% vs. 3.1%) and was negatively associated with live birth in both the hCG trigger (OR 0.28, 95% CI 0.11-0.73) and agonist trigger cohorts (OR 0.35, 95% CI 0.14-0.90). When P ≥2 ng/mL, the live birth rates were poor and similar in the hCG and GnRH-a cohorts (5.9% vs. 14.2%), indicating that P ≥2 ng/mL had a similar negative effect on live birth in both cohorts.
CONCLUSION(S): Elevated serum P on the day of hCG was negatively associated with live birth rates in both hCG and GnRH-a trigger cycles.
Предметные рубрики MeSH
AdultBiomarkersChorionic GonadotropinEmbryo TransferFemaleFertilityFertility Agents, FemaleFertilization in VitroGonadotropin-Releasing HormoneHumansInfertilityLive BirthMiddle AgedOdds RatioOvaryOvulationOvulation InductionPregnancyPregnancy RateProgesteroneRetrospective StudiesRisk FactorsTreatment OutcomeUp-RegulationYoung Adult