Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

The early luteal hormonal profile in IVF patients triggered with hCG

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Parenthood among men diagnosed with cancer in childhood and early adulthood: trends over time in a Danish national cohort

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Prenatal exposure to maternal stressful life events and earlier age at menarche: the Raine Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Chance of live birth: a nationwide, registry-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Familial resemblance in markers of testicular function in fathers and their young sons: a cross-sectional study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Proteome of fluid from human ovarian small antral follicles reveals insights in folliculogenesis and oocyte maturation

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Proteome of fluid from human ovarian small antral follicles reveals insights in folliculogenesis and oocyte maturation

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. N-acetylcysteine protects ovarian follicles from ischemia-reperfusion injury in xenotransplanted human ovarian tissue

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Umbilical cord blood-derived platelet-rich plasma: a clinically acceptable substitute for fetal bovine serum?

    Research output: Contribution to journalEditorialResearchpeer-review

  4. Parental Acceptance Rate of Testicular Tissue Cryopreservation in Danish Boys with Cryptorchidism

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation

    Research output: Contribution to journalReviewResearchpeer-review

View graph of relations

STUDY QUESTION: What is the early luteal phase hormonal profile in patients undergoing ovarian stimulation for IVF/ICSI followed by hCG trigger and a freeze-all strategy without luteal phase support? SUMMARY ANSWER: The peak concentration of progesterone occurred 4 days after oocyte pick-up (OPU + 4), with an average 35% fall from OPU + 4 to OPU + 6, and progesterone levels before and 12 h after hCG administration predicted levels during the early luteal phase. WHAT IS KNOWN ALREADY: The luteal phase during IVF differs from that during normal cycles, particularly with respect to the serum progesterone level profile. This can cause asynchrony between the embryo and the endometrium, potentially resulting in implantation failure and poor reproductive outcomes. STUDY DESIGN, SIZE, DURATION: This prospective study included 161 women with normal ovarian reserve receiving GnRH antagonist co-treatment during ovarian stimulation with FSH who were followed up to 6 days after OPU in a single IVF cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS: Women aged 18-42 years undergoing IVF with ovarian stimulation using FSH were included. Ovulation was triggered with recombinant hCG 250 μg. Hormone levels were determined from blood samples taken on the day of trigger, before hCG, at 12, 24 and 36 h after hCG and at 1, 2, 3, 4, 5 and 6 days after OPU. The primary endpoint was early luteal phase serum concentrations of progesterone, LH, estradiol and hCG. MAIN RESULTS AND THE ROLE OF CHANCE: One outlier with a pre-hCG serum progesterone level of 11.42 ng/mL was excluded, so all analyses included 160 subjects. Progesterone levels began to increase 1 day after OPU, peaked 4 days after OPU (114 ng/mL), then declined from OPU + 5 onwards. Peak progesterone levels were at OPU + 4, OPU + 5 or OPU + 6 in 38.8, 29.4 and 13.8% of patients, respectively. Approximately two-thirds of patients had a fall in serum progesterone from OPU + 4 to OPU + 6. Pre-hCG progesterone levels correlated significantly with those at 24 h after hCG (r 2 = 0.28; P < 0.001), which in turn correlated significantly with progesterone at OPU + 4 (r 2 = 0.32; P < 0.001). LH peaked (4.4 IU/L) 12 h after hCG trigger, persisting for 24 h but was barely elevated compared with physiological levels. Serum estradiol peaked twice: At 24 h post-trigger and at OPU + 4. Highest hCG levels (130 mIU/mL) occurred at 24 h post-injection. The best correlations between the number of follicles ≥11 mm and serum progesterone level were seen at 24 and 36 h after hCG and OPU + 1. LIMITATIONS, REASONS FOR CAUTION: The influence of different profiles of serum progesterone on reproductive outcomes could not be determined because a freeze-all strategy was used in all patients. In addition, data were not available to relate serum hormone level findings with endometrial histology or endometrial receptivity analysis to clearly identify the relationship between serum hormones and the window of implantation. WIDER IMPLICATIONS OF THE FINDINGS: Detailed information about early luteal phase hormone levels could be used to optimize and individualize luteal phase support to improve reproductive outcomes. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by My Duc Hospital, Ho Chi Minh City, Vietnam. All authors state that they have no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER: NCT02798146; NCT03174691.

Original languageEnglish
JournalHuman reproduction (Oxford, England)
Volume35
Issue number1
Pages (from-to)157-166
Number of pages10
ISSN0268-1161
DOIs
Publication statusPublished - 1 Jan 2020

    Research areas

  • hormones, human chorionic gonadotropin, in vitro fertilization, luteal phase, luteinizing hormone, progesterone

ID: 61261261