The Level of Serum Progesterone on the day of HCG Administration in Assisted Reproduction Cycles

Introduction: During stimulated IVF- ET cycle spontaneous LH surge occur in about 20 – 50 % of cycle stimulated with gonadotropin without the pituitary suppression of GnRH agonist. This has been related to maturation and recovery of oocyte together decrease fertilization and implantation rate, this spontaneous LH surge is associated with increase in serum progesterone , so without pituitary suppression with GnRH , the rise of serum progesterone in the per ovulatory period may indicate the occurrence of spontaneous of LH surge, the aim of study is to indicate cutoff point of progesterone in the day of HCG administration. Method: This was a retrospective, non-interventional cohort study of patients undergoing ICSI at Tiba infertility center in Babylon, from period 2015 - 2019, all patient age from 20 – 45 years old under long protocol, had at least one grade I embryo transferred, total amount of patients was 1457. At second day of menstrual cycle we stimulate by used recombinant FSH, measured on second day of menstruation serum FSH, LH and estrogen levels, transvaginal ultrasound used to monitored the follicles. when follicle became 14 mm in size we used antagonist. 3 or more follicles gotten 18 mm in diameter. Activation gave either hCG alone or mixture of hCG and agonist. After 14 days from embryo transfer we checked HCG and after that after 10 days transvaginal ultrasound was done. Results: In our study showed the significant association between positive pregnancy outcome and progesterone level at day of HCG trigger were 79.2 % of female with positive pregnancy at progesterone level < 1.5, while 9.3 % of female with positive pregnancy at progesterone level > 2.5, There is a significant differences of LH at day of HCG activate rendering to progesterone level day of HCG activate, progesterone level ( < 1.5) had more chief level at day of HCG activate with mean and SD (5.38 ± 2.52), and reduction when the level progesterone rise. Conclusion: pregnancy cannot depend on progesterone level at day when HCG administration for assisted reproduction cycles treated with GnRH agonists and gonadotrophins. So cutoff point of progesterone can reach to above 1.5 ng/ ml and expected of pregnancy at this level.