Progesterone to Oocyte Index – a Novel Predictor For Fresh ivf cycle Outcome - Israeli Fertility Association Conference-Ayala 2017, May 8-9, 2017

Leonti Grin ¹ Yossi Mizrachi ² Tal Lazer ¹ Gad Liberty ¹ Simion Meltcer ¹ Shevach Friedler ¹

¹Infertility and IVF Unit, Barzilai University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev
²OBGYN, Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University

Introduction: The potential adverse influence of Serum progesterone (SP) elevation on the day of hCG administration on ART cycles outcome is a matter of continued debate.

Aim: to evaluate the relative value of (SP), Progesterone to follicle index (PFI) and Progesterone to number of oocytes aspirated index (POI) in predicting live birth rate in fresh IVF cycles.

Material and Methods: All patients treated at the IVF unit between Jan 2010 and Dec 2015 with a GnRH antagonist protocol. The progesterone to follicles index (PFI) and the progesterone to oocytes index (POI) were calculated by dividing the SP at hCG administration day by the number of follicles ≥15mm or by the number of retrieved oocytes, respectively. Cycle outcome parameters included clinical pregnancy, live-birth and miscarriage.

Results: A total of 2,493 IVF/ICSI cycles were analyzed. POI was inversely associated with clinical pregnancy (aOR 0.063; 95% CI 0.016-0.249; P<0.001), and with live birth (aOR 0.036; 95% CI 0.007-0.199; P<0.001). Above the 90th decile of POI (0.360 ng/ml/oocyte), CPR and LB decreased to 8.0% and 5.9%, respectively.

Conclusions: Based on our analysis of a large cohort of patients treated at a single center, POI had the best predictive value for prediction of Live-birth, superior to PFI and SP.