P-219: Premature Progesterone Rise (PPR) At HCG Triggering Day Has No Correlation with ICSI Outcome: A Prospective Cohort Study

Background: The objective of this study is to evaluate the progesterone level (P Level) on the day of HCG triggering in GnRh agonist and antagonist protocols, and its correlation with clinical pregnancy rate and miscarriage rate. Premature luteinization during in vitro fertilization (IVF) was commonly happened before the introduction of GnRh analogues. High level of unwanted progesterone that is associated with adverse pregnancy outcome is thought to be induced by inappropriate LH elevation. Materials and Methods: One hundred and seven women underwent intracytoplasmic sperm injection with long agonist protocol (n=46) or antagonist protocol (n=61). Blood sample was obtained from each patient for progesterone level measurement in HCG administration day. Clinical pregnancy and miscarriage rates were evaluated as main outcomes and biochemical pregnancy rate and implantation rate were considered as secondary outcomes. Results: The increased prevalence rate of premature progesterone (P≥1.2 ng/ml) in total patients was 13.1% (14/107) and in long agonist protocol group and antagonist protocol group was 15.2 % (7/46) and 11.5% (7/61) respectively. premature progesterone rise(PPR) had no significant correlation with clinical pregnancy rate in total patients(p=0.174),agonist protocol (p=0.545), and antagonist protocol (p=0.129). Also premature progesterone rise had no significant association with miscarriage rate in all of the understudied patients. Conclusion: A significant rise in progesterone levels at the time of HCG triggering doesn’t lead to a decrease in pregnancy rate and implantation rate and an increase in miscarriage rate.