The Relationship Between Progesterone Level On Trigger Day And Pregnancy Outcome

Objective1.To investigate effect of progesterone level on the day of h CG administration on embryo quality and pregnancy outcomes of cycles with long-acting Gn RH agonist protocol in follicular phase.2.To explore the factors that affect the elevation of progesterone on trigger day in long-acting Gn RH agonist protocol in follicular phase.MethodsA retrospective analysis was performed on the data of 511 women who received the long-acting Gn RH agonist protocol in follicular phase of controlled ovarian stimulation in the reproductive medicine center of Anhui Maternal and Child Health Hospital from January 2014 to December 2020.All cycles were divided into group A（progesterone ≥1.5 ng/m L）and group B（progesterone <1.5ng/m L）,Comparison of the number of oocytes retrieved and the quality of embryos between groups A and B.All fresh embryo transfer cycles were divided into A1 group（progesterone ≥1.5 ng/m L） and B1 group（progesterone <1.5 ng/m L）,Comparison of the pregnancy outcomes between groups A and B.logistic regression analysis was performed to analysis age,duration of infertility,BMI,basic FSH level,basic LH level,total dose of gonadotropin,total time of gonadotropin,priming dose of gonadotropin,number of eggs retrieved,number of oocytes retrieved which factors were relevant to serum P levels on the day of HCG injection.The receiver operating characteristic（ROC）curve of the obtained factors was used to obtain the cut-off value for predicting the increase of progesterone on the trigger day.Results1.There were no statistically significant differences in age,duration of infertility,BMI,basic FSH level,basic LH level,total dose of gonadotropin,total time of gonadotropin,priming dose of gonadotropin,endometrial thickness on trigger day between groups A and B in all long-acting Gn RH agonist protocol in follicular phase of controlled ovarian stimulation cycles.2.The number of oocytes retrieved,the number of mature oocytes and the number of normal fertilization in group A were higher than those in group B,and the difference was statistically significant（P<0.05）.3.There was no statistical difference in basic data such as age,years of infertility,basal FSH,basal LH,Gn starting dose,Gn time,total Gn dose,and endometrial thickness on trigger day between groups A and B in all fresh embryo transfer cycles.4.The embryo implantation rate and clinical pregnancy rate of group A1 were lower than those of group B1,and the difference was statistically significant（P<0.05）.5.Logistic regression analysis showed that BMI and the number of oocytes retrieved were correlated with the increase in progesterone on the trigger day.Conclusions1.The level of progesterone on the trigger day has no significant effect on embryo quality.2.When progesterone is greater than or equal to 1.5ng/m L on the trigger day,the embryo implantation rate and clinical pregnancy rate will decrease after fresh embryo transfer.3.A decrease in BMI and an increase in the number of oocytes retrieved lead to an increase in progesterone levels on the trigger day...