Impact of serum progesterone levels on the trigger day on IVF/ICSI-ET outcomes in antagonist protocols
10.3760/cma.j.cn101441-20250408-00173
- VernacularTitle:扳机日血清孕酮水平对拮抗剂方案IVF/ICSI-ET助孕结局的影响
- Author:
Yinfeng ZHANG
1
;
Aomiao HUANG
;
Xinyan WANG
;
Haining LUO
Author Information
1. 天津市中心妇产科医院生殖医学中心 天津市人类发育与生殖调控重点实验室 中西 医协同“旗舰”科室，天津 300100
- Publication Type:Journal Article
- Keywords:
Progesterone;
Antagonist protocol;
Clinical pregnancy rate;
Live birth rate
- From:
Chinese Journal of Reproduction and Contraception
2025;45(10):1026-1031
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the optimal threshold for trigger-day progesterone levels in gonadotropin-releasing hormone (GnRH) antagonist protocols.Methods:A cohort study was performed. The clinical data were retrospectively analyzed from patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) for assisted reproduction at the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital between January 2014 and May 2023. The study included 5 760 fresh transfer cycles where the female partner had undergone ovarian stimulation using a GnRH antagonist protocol. This was a single-arm study. The primary outcome measures were clinical pregnancy rate and live birth rate. The association between progesterone level on the trigger day and clinical pregnancy outcome and the dose-response relationship were analyzed by restricted cubic spline. Results:The progesterone level on the day of human chorionic gonadotropin trigger was (1.33±0.38) μg/L. Among the included cycles, 2 900 cycles underwent conventional IVF fertilization, while 2 860 cycles underwent ICSI. The biochemical pregnancy rate was 44.79% (2 580/5 760), the clinical pregnancy rate was 40.35% (2 324/5 760), and the live birth rate was 31.46% (1 812/5 760). Progesterone levels on the trigger day in GnRH antagonist protocols showed a nonlinear association with both clinical pregnancy rate and live birth rate (both P<0.001). When progesterone levels were below 0.61 μg/L, the clinical pregnancy rate increased with rising progesterone levels, but decreased significantly once this threshold was exceeded. Similarly, the live birth rate increased with progesterone levels below 0.63 μg/L and declined beyond that point. Conclusion:Progesterone levels on the optimal trigger day for achieving the highest clinical pregnancy rate and live birth rate in GnRH antagonist protocols are peak values of 0.61 μg/L and 0.63 μg/L, respectively. Using these thresholds, the impact of progesterone levels on the trigger day shows a positive effect on both clinical pregnancy rate and live birth rate up to these points, after which the effects become negative.
