Shady Grove Fertility Reports Progesterone Level Markers that May Predict Pregnancy Failure

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The nation’s largest fertility center documents clinical discoveries at the 2014 ASRM Annual Meeting.

Chronic elevations in progesterone may be a more useful clinical marker to predict pregnancy failure than only looking at progesterone levels on the day of the hCG trigger.

Shady Grove Fertility, a recognized leader in infertility research, has announced the results of a study observing how progesterone levels can be used to measure possible pregnancy failure in fertility patients. Three Day Progesterone Area Under the Curve: A Better Test than Progesterone on the Day of hCG will be presented by Dr. G. Donald Royster IV, et al., on Wednesday, October 22 at 11:30 a.m. at the 2014 American Society for Reproductive Medicine (ASRM) Annual Meeting in Honolulu, Hawaii.

During a woman’s menstrual cycle, progesterone is released during ovulation. Progesterone is a critical hormone necessary for embryos to implant in a woman’s uterine cavity. As egg retrieval replaces ovulation in an in vitro fertilization (IVF) cycle, the release of progesterone is determined by the trigger shot, which is comprised of human chorionic gonadotropin (hCG). When Shady Grove Fertility researchers looked at factors impacting patient pregnancy rates, they found a suggested correlation between a woman’s elevated progesterone level at the time of her ovulation trigger and a decrease in implantation and pregnancy rates. This information has given physicians the ability to modify treatment accordingly in order to improve patient success. Consequently, physicians have decided to expand this research further to see if elevated progesterone levels could be discerned even earlier.

“By monitoring our patients’ progesterone levels on the days leading up to the trigger shot – as well as on that day – we now have a more accurate look at the potential success of a cycle’s outcome,” said Eric A. Widra, M.D., medical director of Shady Grove Fertility.

Researchers from Shady Grove Fertility, the National Institute of Child Health and Human Development (NICHD), and the National Institutes of Health (NIH) collaborated on this inquiry. 1,448 patients undergoing 1,620 fresh autologous cycles were identified. Progesterone levels were measured for each of the three days prior to the hCG trigger in addition to the day of the trigger itself.

The study concluded that elevated levels of progesterone in the days leading up to the hCG trigger had a stronger negative outcome on pregnancy rates. For those with elevated rates that were present three days prior to the hCG trigger, the positive predictive power (PPV) for pregnancy failure was 76 percent compared to 69 percent for elevated progesterone levels on the day of the hCG trigger. Thus, chronic elevations in progesterone may be a more useful clinical marker to predict pregnancy failure than only looking at progesterone levels on the day of the hCG trigger. This will ultimately help physicians more accurately identify cycles at risk of pregnancy failure, enabling them to alter treatment to provide patients with the greatest chance of a successful outcome.

Royster IV, G. Donald, Hill, Micah J., Zarek, Shvetha M., DeCherney, Alan H., Levens, Eric, Widra, Eric & Levy, Michael J. (2014). Three day progesterone area under the curve: a better test than progesterone on the day of hCG? Abstract retrieved from Fertility and Sterility Sept. 2014: Volume 102, issue 3, e85-e86.

About Shady Grove Fertility: Shady Grove Fertility is America’s largest and most dynamic fertility center. 31 reproductive endocrinologists – as well as PhD scientists, geneticists and 480 highly specialized staff – care for patients in 18 full-service offices and 3 satellite locations throughout the Philadelphia, Baltimore, and Washington, DC metropolitan areas. SGF offers a comprehensive range of treatment options for those needing fertility treatment or egg freezing, as well as resources to address patients’ needs - medical, emotional, and financial. For patient convenience, IVF retrievals for fertility treatment and egg freezing are now performed at three regional centers in Rockville, MD; Towson, MD; and Chesterbrook, PA.

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