Title: Elevated progesterone-to-estradiol ratio versus serum progesterone alone for predicting poor cycle outcome with in vitro fertilization.

Authors: Keltz, Martin D; Stein, Daniel E; Berin, Inna; Skorupski, Josh

Published In J Reprod Med, (2012 Jan-Feb)

Abstract: To determine whether a progesterone-to-estradiol (P/E2) ratio on day of human chorionic gonadotropin (hCG) administration would be a better predictor of in vitro fertilization (IVF) outcome than serum P alone.All 348 fresh IVF cycles performed in 2002 and 2003 at a university hospital center were reviewed for all cycle parameters as related to the peak P and peak P/E2 ration on day hCG administration.Out of the 348 cycles performed, 199 cycles resulted in clinical pregnancies. The mean P level (1.4 ng/mL) was equivalent in both conception and nonconception cycles. A P/E2 ratio > 1.0, however, was associated with a highly significant reduction in clinical pregnancy rate (38.2% vs. 62.6%, p< 0.01) and live birth rate (35.4% vs. 49.1%, p = 0.02).Cycles with elevated P/E2 ratios are associated with lower clinical pregnancy and live birth rates, which decrease further as the P/E2 ratio rises. P/E2 ratio improves the prediction of IVF outcome when compared to serum P levels alone.

PubMed ID: 22324261

MeSH Terms: Adult; Chorionic Gonadotropin/administration & dosage; Dose-Response Relationship, Drug; Embryo Transfer; Estradiol/blood*; Female; Fertility Agents, Female/administration & dosage; Fertilization in Vitro*; Humans; Infertility, Female/blood*; Infertility, Female/therapy*; Pregnancy; Pregnancy Outcome/epidemiology*; Pregnancy Rate; Progesterone/blood*