Association Between Progesterone Level on Trigger Day to Basal Progesterone Ratio and in vitro Fertilization-Embryo Transfer Outcomes in Antagonist Protocols
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objective: To investigate the relationship between the progesterone level on trigger day (P trigger ) to basal progesterone (bP) ratio and the outcomes of in vitro fertilization-embryo transfer (IVF-ET). Methods: A retrospective analysis was conducted on women who received an antagonist protocol, with a P trigger less than 1.5 ng/mL and who underwent fresh embryo transfer. Based on the P trigger /bP ratio, participants were categorized into four groups: group A (P trigger /bP < 1, n = 284), group B (P trigger /bP ≥ 1 and < 2, n = 363), group C (P trigger /bP ≥ 2 and < 3, n = 165), and group D (P trigger /bP ≥ 3, n = 118). Recombinant follicle-stimulating hormone was used to stimulate ovulation. Receiver operating characteristic curve analysis was used to analyze the accuracy of the P trigger /bP ratio in predicting clinical pregnancy following fresh embryo transfer. Results: A decreasing trend in bP levels was observed across groups (A > B > C > D), while P trigger levels showed an increasing trend (A < B < C < D). Groups A and B included significantly younger women and required lower doses of gonadotropin (Gn) compared to Groups C and D. The embryo implantation and clinical pregnancy rates in Group A were 34.93% and 49.30%, respectively, significantly higher than those in Group D (23.19% and 33.90%, respectively). After propensity score matching for age, the differences in implantation and clinical pregnancy rates were not statistically significant between Group A and D. The P trigger/ bP ratio had limited accuracy in predicting clinical pregnancy, with an area under the curve of 0.538 (95% CI [confidence interval]: 0.501– 0.575, P = 0.044 ). Conclusion: A P trigger /bP ratio of less than 1 was associated with relatively favorable pregnancy outcomes in women undergoing IVF-ET with an antagonist protocol for ovulation induction. Keywords: antagonist protocol, basal progesterone, bP, IVF-ET outcome, in vitro fertilization-embryo transfer, IVF-ET, progesterone level on trigger day, P trigger
DOI: 10.2147/ijwh.s506574
Authors: Miao-Yi Xu, Yu-Ting Wang, Yao-Fang Liu
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
OpenAlex ID: W4408226822
