GnRH Antagonist Protokolu ve Taze Embriyo Transferi Uygulanan Tup Bebek Hastalarinda Ovulasyonun Tetiklendiǧi Gun Progesteron/Folikul Oraninin Canli Doǧum oranini ongormedeki rolu

Objective: The purpose of this retrospective cohort study was to establish a ratio of the progesterone level to the number of follicles (having diameter larger than 12 mm) on ovulation trigger day [human chorionic gonadotropin (hCG)-day] and to demonstrate if this ratio is associated with pregnancy outcome in gonadotropin releasing hormone (GnRH) antagonist/intracytoplasmic sperm injection cycles with high hCG-day serum progesterone value (≥1.5 ng/mL). Material and Methods: Among 2.111 GnRH antagonist cycles which were conducted at Izmir Tepecik Education and Research Hospital, Gynecology and Obstetrics Clinic, In Vitro Fertilization Center between March 2010-July 2015, 203 cycles matching inclusion criteria and with serum progesterone levels ≥1.5 ng/mL on hCG day were included in the analysis. Following controlled ovarian stimulation, serum progesterone levels and the follicle diameters were measured on hCG-day. In addition, the basal demographic and hormonal data, the embryo development data after oocyte pick-up process, and the pregnancy results were included in the analysis. Results: In this study, the receiver operating characteristics area under curve value, cut-off value, sensitivity and specificity were found to be 0.617, 0.307, 0.97 and 0.24 for progesterone/follicle ratio (P/F ratio), respectively (p=0.023). In addition, it was also found in our study that while the total follicle stimulating hormone amount used and hCG day progesterone level in patients, who have P/F ratio value ≤0.307 was significantly lower (p<0.01, p<0.001); whereas hCG-day ≥12 mm and ≥17 mm follicle number, hCG-day endometrial thickness, hCGday estradiol level, total and metaphase II oocyte number were significantly higher in patients with P/F ratio ≤0.307. Moreover, chemical, clinical, ongoing pregnancy and live birth rates were significantly higher in patients with P/F ratio ≤0.307. Conclusions: As a conclusion, in patients with hCG-day serum progesterone levels ≥1.5 ng/mL, progesterone/follicle ratio is a useful parameter in predicting live birth rate in patients undergoing fresh embryo transfer and antagonist IVF cycle.