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Relationship of serum progesterone level the day of pick up oocytes on outcome following in vitro fertilization-embryo transfer
REPRODUCTIVE HORMONES P-629 Wednesday, October 16, 2013 COMPARISON OF HOME PREGNANCY TEST WITH WEEKS ESTIMATOR AND ULTRASOUND CROWN RUMP MEASUREMENT TO PREDICT DELIVERY DATE. S. Johnson, S. Godbert. SPD Development Company Ltd, Bedford, Bedfordshire, United Kingdom. OBJECTIVE: A new home pregnancy test is available, which as well as determining whether a woman is pregnant or not, provides an estimate of the number of weeks since ovulation for women testing pregnant (1-2, 2-3, 3+ weeks). A prospective study has found the ‘‘weeks estimator’’ to be 93% in agreement with time since ovulation (by LH surge). The objective of this study was to compare its prediction of final delivery date in comparison to ultrasound. DESIGN: A random sample of urine samples obtained pre-conception until approximately 8 weeks gestational age (GA, equivalent to 6 weeks post ovulation), were tested using Clearblue Advanced Pregnancy Test with Weeks Estimator. The device results were used to determine the duration of pregnancy (from ovulation) on delivery day. For comparison purposes, the duration of pregnancy from ovulation (GA-14 days) to delivery day was also calculated using ultrasound crown rump length (CRL) measurement. MATERIALS AND METHODS: Data from volunteers with a natural delivery (n¼46) from the standard-of-care ultrasound study (UK) and the Gestational age study (US), were analysed. Urine samples were tested in laboratory using the device (n¼458 devices) and CRL was converted to GA using the Hadlock formula. RESULTS: Mean age of volunteers was 30.48 (range 23-41), and all pregnancies were singleton. The mean time from device result (time since ovulation) to delivery was 37.47 weeks (SD 1.52), 95% Confidence Interval 37.02-37.92, range 33.07-39.91. The mean time from ovulation to delivery based on CRL measurement was 37.40 (SD 1.75), 95% Confidence Interval 36.88-37.92, range 33-41.57. CONCLUSION: Both methods provided comparable predictions of delivery date, with a slightly broader range seen using CRL measurement. The mean duration of time from ovulation to delivery was consistent with the typically reported 38 weeks. Therefore the new pregnancy test’s ‘‘weeks estimator’’ provides results that are consistent with ultrasound. Supported by: The study was funded by SPD Development Company Ltd.
P-630 Wednesday, October 16, 2013 NOMOGRAM TO PREDICT ONGOING PREGNANCY USING AGE OF WOMEN AND SERUM BIOMARKERS IN VITRO FERTILIZATION CYCLES. S. Kim,a B. Jee,b S. Kim.b aMaria Plus Fertility Hospital, Seoul, Republic of Korea; bOBGY, Seoul National Univerity College of Medicine, Seoul, Republic of Korea. OBJECTIVE: To develop a nomogram for prediction of ongoing pregnancy after in vitro fertilization (IVF)-embryo transfer (ET) using age of women and serum biomarkers. DESIGN: Prospective longitudinal study of 103 patients undergoing IVFET at a University-based hospital. MATERIALS AND METHODS: Serum hCG and progesterone level was measured at the time of the pregnancy test (14 days post-oocyte retrieval) and pregnancy outcomes were followed. Main outcome was ongoing pregnancy prediction. RESULTS: For the prediction of ongoing pregnancy, combination of serum hCG, progesterone and age of women shows the best predictive accuracy (AUC 0.912 [95% CI 0.815-1.000], sensitivity 89.3%, specificity 80.0%, positive predictive value 89.3%, negative predictive value 80.0%). On the basis of these variables, we developed a nomogram to predict ongoing pregnancy. CONCLUSION: A nomogram could help to predict ongoing pregnancy after IVF-ET. The nomogram needs further validation to improve individualized prediction of ongoing pregnancy. Supported by: This work was Supported by grant no. A120043 from the Korea Health Care Technology R&D Project, Ministry of Health and Welfare, Korea.
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ASRM Abstracts
P-631 Wednesday, October 16, 2013 PREMATURE LUTEINIZATION AFFECT IVF OUTCOME IN CONTROLLED OVARIAN STIMULATION (COS) CYCLES USING FLEXIBLE ANTAGONIST PROTOCOL. H. S. Koo, M. H. Choi, I. O. Song, I. S. Kang, M. K. Koong, C. W. Park. Division of Reproductive Endocrinology and Infertility, Department OB/GYN, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Republic of Korea. OBJECTIVE: To investigate the relationship between serum progesterone (P4) levels on the hCG day and the IVF outcomes in the women undergoing COS for IVF/ICSI-ET using flexible antagonist protocol. DESIGN: The prospective study included a total 148 cycles of 148 IVF and/or ICSI-ET patients using flexible antagonist protocol from May, 2012 to June, 2012. MATERIALS AND METHODS: The serum P4 levels were checked on the day of hCG administration. We take the cut-off value for premature luteinization as 0.97ng/mL which was the 75 percentile value of P4 level on hCG day. IVF outcomes such as No. of retrieved oocytes, maturation rate, fertilization rate, implantation rate, clinical pregnancy rate (CPR), miscarriage rate (MR) were compared according to P4 level. The correlation factors with P4 level were analysed with regression analysis and the cut-off value for each correlation factor was taken 75 percentile value. RESULTS: The incidence of premature luteinization was 26% (39/148). There was no difference in the mean age (33.9 2.7 vs. 33.6 2.7). The serum E2 level (42632366 pg/ml vs. 22701421 pg/ml, p<0.001), No. of retrieved oocytes (16.96.9 vs. 10.26.3, p<0.01) was significantly higher in low P4 group (P4%0.97) and CPR (39.4 % vs. 20.5 %, p¼0.033) was significantly higher in low P4 than high P4 group (P4>0.97). The serum P4 level showed significant positive correlation with serum E2 level and No. of retrieved oocytes. When P4 level was combined with No. of oocytes retrieved, the CPR (37.5 % vs. 15.05 %, p¼0.049) and IR (17.3 % vs. 6.7 %, p¼0.025) was significantly higher in low P4 (P4%0.97) and No. of oocytes (No.%16) group than those of high P4 (>0.97) and No. of oocytes (No.>16) group. CONCLUSION: Premature luteinization, elevated serum P4 level on the day of hCG, is associated with lower CPR although No. of retrieved oocytes is higher. Measuring serum P4 values at the time of HCG is necessary in order to adjust the strategy for embryo transfer. The larger scaled prospective study will be required. P-632 Wednesday, October 16, 2013 RELATIONSHIP OF SERUM PROGESTERONE LEVEL THE DAY OF PICK UP OOCYTES ON OUTCOME FOLLOWING IN VITRO FERTILIZATION-EMBRYO TRANSFER. J. C. Garcıa Lozano, M. Dorado, E. Traverso Morcillo, E. Troncoso Dantas, P. Sanchez Martın, F. Sanchez Martın. Unidad de Reproduccion, Clinicas Ginemed, Seville, Spain. OBJECTIVE: We know the influence of serum progesterone levels on the day of HCG in the pregnancy rate per transfer of fresh IVF cycles. The aim of this study is to assess whether the levels of progesterone the day of pick up oocytes may influence the pregnancy rate per fresh transfer of IVF cycles. DESIGN: Observational study. MATERIALS AND METHODS: Observational study on 282 women who underwent the IVF cycle with fresh embryo transfer. Determination of pregesterone levels was made at the day of the follicular puncture. The primary end point was the clinical pregnancy rate per fresh transfer. RESULTS: The average value of progesterone puncture day was 8.18 ng / ml ( 4.35). Patients were divided into four groups based on progesterone levels: 0-5 ng / ml (n¼67), 5-7 ng / ml (n¼75), 7-10 ng / ml (n¼64) and> 10 ng / ml (n¼76). The transfer pregnancy rates obtained in the different groups was: 37.3%, 45.3%, 56.3% and 39.5% respectively. Pregnancy per transfer rate obtained in the group of 7 to 10 ng / ml was significantly higher when compared with the group of 0-5 ng / ml (RR ¼ 1.51, p ¼ 0.02) and the group of > 10 ng / ml (RR ¼ 1.42, p ¼ .04). CONCLUSION: The average value of progesterone puncture day was 8.18 ng / ml ( 4.35). Patients were divided into four groups based on progesterone levels: 0-5 ng / ml (n¼67), 5-7 ng / ml (n¼75), 7-10 ng / ml (n¼64) and> 10 ng / ml (n¼76). The transfer pregnancy rates obtained in the different groups was: 37.3%, 45.3%, 56.3% and 39.5% respectively. Pregnancy per transfer rate obtained in the group of 7 to 10 ng / ml was significantly higher when compared with the group of 0-5 ng / ml (RR ¼ 1.51, p ¼ 0.02) and the group of > 10 ng / ml (RR ¼ 1.42, p ¼ .04). Supported by: Fundacion Ginemed.
Vol. 100, No. 3, Supplement, September 2013
P-630 Wednesday, October 16, 2013 NOMOGRAM TO PREDICT ONGOING PREGNANCY USING AGE OF WOMEN AND SERUM BIOMARKERS IN VITRO FERTILIZATION CYCLES. S. Kim,a B. Jee,b S. Kim.b aMaria Plus Fertility Hospital, Seoul, Republic of Korea; bOBGY, Seoul National Univerity College of Medicine, Seoul, Republic of Korea. OBJECTIVE: To develop a nomogram for prediction of ongoing pregnancy after in vitro fertilization (IVF)-embryo transfer (ET) using age of women and serum biomarkers. DESIGN: Prospective longitudinal study of 103 patients undergoing IVFET at a University-based hospital. MATERIALS AND METHODS: Serum hCG and progesterone level was measured at the time of the pregnancy test (14 days post-oocyte retrieval) and pregnancy outcomes were followed. Main outcome was ongoing pregnancy prediction. RESULTS: For the prediction of ongoing pregnancy, combination of serum hCG, progesterone and age of women shows the best predictive accuracy (AUC 0.912 [95% CI 0.815-1.000], sensitivity 89.3%, specificity 80.0%, positive predictive value 89.3%, negative predictive value 80.0%). On the basis of these variables, we developed a nomogram to predict ongoing pregnancy. CONCLUSION: A nomogram could help to predict ongoing pregnancy after IVF-ET. The nomogram needs further validation to improve individualized prediction of ongoing pregnancy. Supported by: This work was Supported by grant no. A120043 from the Korea Health Care Technology R&D Project, Ministry of Health and Welfare, Korea.
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ASRM Abstracts
P-631 Wednesday, October 16, 2013 PREMATURE LUTEINIZATION AFFECT IVF OUTCOME IN CONTROLLED OVARIAN STIMULATION (COS) CYCLES USING FLEXIBLE ANTAGONIST PROTOCOL. H. S. Koo, M. H. Choi, I. O. Song, I. S. Kang, M. K. Koong, C. W. Park. Division of Reproductive Endocrinology and Infertility, Department OB/GYN, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Republic of Korea. OBJECTIVE: To investigate the relationship between serum progesterone (P4) levels on the hCG day and the IVF outcomes in the women undergoing COS for IVF/ICSI-ET using flexible antagonist protocol. DESIGN: The prospective study included a total 148 cycles of 148 IVF and/or ICSI-ET patients using flexible antagonist protocol from May, 2012 to June, 2012. MATERIALS AND METHODS: The serum P4 levels were checked on the day of hCG administration. We take the cut-off value for premature luteinization as 0.97ng/mL which was the 75 percentile value of P4 level on hCG day. IVF outcomes such as No. of retrieved oocytes, maturation rate, fertilization rate, implantation rate, clinical pregnancy rate (CPR), miscarriage rate (MR) were compared according to P4 level. The correlation factors with P4 level were analysed with regression analysis and the cut-off value for each correlation factor was taken 75 percentile value. RESULTS: The incidence of premature luteinization was 26% (39/148). There was no difference in the mean age (33.9 2.7 vs. 33.6 2.7). The serum E2 level (42632366 pg/ml vs. 22701421 pg/ml, p<0.001), No. of retrieved oocytes (16.96.9 vs. 10.26.3, p<0.01) was significantly higher in low P4 group (P4%0.97) and CPR (39.4 % vs. 20.5 %, p¼0.033) was significantly higher in low P4 than high P4 group (P4>0.97). The serum P4 level showed significant positive correlation with serum E2 level and No. of retrieved oocytes. When P4 level was combined with No. of oocytes retrieved, the CPR (37.5 % vs. 15.05 %, p¼0.049) and IR (17.3 % vs. 6.7 %, p¼0.025) was significantly higher in low P4 (P4%0.97) and No. of oocytes (No.%16) group than those of high P4 (>0.97) and No. of oocytes (No.>16) group. CONCLUSION: Premature luteinization, elevated serum P4 level on the day of hCG, is associated with lower CPR although No. of retrieved oocytes is higher. Measuring serum P4 values at the time of HCG is necessary in order to adjust the strategy for embryo transfer. The larger scaled prospective study will be required. P-632 Wednesday, October 16, 2013 RELATIONSHIP OF SERUM PROGESTERONE LEVEL THE DAY OF PICK UP OOCYTES ON OUTCOME FOLLOWING IN VITRO FERTILIZATION-EMBRYO TRANSFER. J. C. Garcıa Lozano, M. Dorado, E. Traverso Morcillo, E. Troncoso Dantas, P. Sanchez Martın, F. Sanchez Martın. Unidad de Reproduccion, Clinicas Ginemed, Seville, Spain. OBJECTIVE: We know the influence of serum progesterone levels on the day of HCG in the pregnancy rate per transfer of fresh IVF cycles. The aim of this study is to assess whether the levels of progesterone the day of pick up oocytes may influence the pregnancy rate per fresh transfer of IVF cycles. DESIGN: Observational study. MATERIALS AND METHODS: Observational study on 282 women who underwent the IVF cycle with fresh embryo transfer. Determination of pregesterone levels was made at the day of the follicular puncture. The primary end point was the clinical pregnancy rate per fresh transfer. RESULTS: The average value of progesterone puncture day was 8.18 ng / ml ( 4.35). Patients were divided into four groups based on progesterone levels: 0-5 ng / ml (n¼67), 5-7 ng / ml (n¼75), 7-10 ng / ml (n¼64) and> 10 ng / ml (n¼76). The transfer pregnancy rates obtained in the different groups was: 37.3%, 45.3%, 56.3% and 39.5% respectively. Pregnancy per transfer rate obtained in the group of 7 to 10 ng / ml was significantly higher when compared with the group of 0-5 ng / ml (RR ¼ 1.51, p ¼ 0.02) and the group of > 10 ng / ml (RR ¼ 1.42, p ¼ .04). CONCLUSION: The average value of progesterone puncture day was 8.18 ng / ml ( 4.35). Patients were divided into four groups based on progesterone levels: 0-5 ng / ml (n¼67), 5-7 ng / ml (n¼75), 7-10 ng / ml (n¼64) and> 10 ng / ml (n¼76). The transfer pregnancy rates obtained in the different groups was: 37.3%, 45.3%, 56.3% and 39.5% respectively. Pregnancy per transfer rate obtained in the group of 7 to 10 ng / ml was significantly higher when compared with the group of 0-5 ng / ml (RR ¼ 1.51, p ¼ 0.02) and the group of > 10 ng / ml (RR ¼ 1.42, p ¼ .04). Supported by: Fundacion Ginemed.
Vol. 100, No. 3, Supplement, September 2013