Effect of serum progesterone on the day of trigger administration to MII oocyte ratio on IVF/ICSI outcomes

Background: To evaluate the effect of serum progesterone on the day of trigger administration to MII oocyte ratio on IVF/ICSI outcomes. Retrospective observational study in Institute of Reproductive Medicine, The Madras Medical Mission, Chennai. Methods: 211 patients meeting inclusion and exclusion criteria were subjected to controlled ovarian stimulation with antagonist protocol and were serially monitored by ultrasound and hormonal blood tests and when at least 3 follicles reach 18 mm size, ovulation is triggered with HCG or GnRH agonist. Serum progesterone levels on the day of trigger were noted and oocyte retrieval done 35 hours after trigger injection and the no. of MII oocytes retrieved were noted. Embryo transfer was done on day 3 of oocyte retrieval. Adequate luteal support was given, Pregnancy test was done 16 days after embryo transfer. Results: On evaluating 211 fresh ICSI–ET cycles, Roc curve was obtained and it showed that when compared with patients with P-trigger/MII oocyte ratio≤0.29 group, patients with P-trigger/MII>0.29 group had a lower clinical pregnancy rate, implantation rate and live birth rate. Conclusions: The present study reveals that an elevated of P-trigger/MII oocyte ratio is inversely correlated with the probability of pregnancy, indicating that this ratio may be a reliable predictor of IVF outcomes. P/MII ratio could also play a key role in selection of patients for cryopreservation of all embryos (elective freeze-all policy) and subsequent transfer of cryopreserved/thawed embryos.