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DATA

Using Assisted Reproduction Technology to Predict Pregnancy Outcomes

H.F. Solomon, R.M. Sneeringer, A.S. Penzias

August 7, 2017
Emma Holt

Serum progesterone level after assisted reproductive technology

The goal of this review completed by H.F. Solomon, R.M. Sneeringer, and A.S. Penzias, is to determine the value of serum progesterone level in patients with a positive pregnancy hormone called Beta HCG, after controlled ovarian hyperstimulation (COH) followed by intrauterine insemination (IUI) or IVF. That’s one hefty objective so we’ll unpack it together.  First of all, progesterone is a hormone that affects a woman’s ability to become and stay pregnant and abnormally high or low levels can be a sign of serious health issues. Women tend to have more of this hormone because it’s produced in the ovaries. Next, COH is a technique often used in assisted reproduction involving the use of fertility medications to induce ovulation.

To put it in simpler terms, the researchers are attempting to determine the value of a hormone (progesterone) and its ability to predict pregnancy with Beta HCG after inducing ovulation (COH) followed by IUI or IVF. Reread a few times and let that sink in.

Materials & Methods

Retrospective chart review 

This study is a little different because the author’s are simply reflecting on all cycles for patients beginning treatment between January 1, 2004 through December 31, 2007 using the Practice Highway EIVF Query research tool. The pregnancy outcomes in the women selected for analysis were compared with progesterone levels and the responsiveness and relevance of progesterone level to predict ongoing pregnancy were determined. For instance, <0.05 was considered a significant statistic.

‍Results & Conclusion

Prediction of pregnancy outcome 

The results were as follow: 142 live births, 97 ongoing clinical pregnancies, 81 spontaneous abortions, 4 elective terminations, 14 ectopic pregnancies (when the fertilized egg attaches itself in a place other than inside the uterus… ouch!), and 61 biochemical pregnancies. (A biochemical pregnancy is when an embryo has implanted and secretion of pregnancy hormone, Beta HCG, has taken place). 

Of the 400 cycles, 284 were IVF treatments and the other 116 were COH with IUI. The average progesterone levels were higher in IVF than IUI cycles and the most favorable outcomes, which were ongoing pregnancy and live birth, generated a significantly higher average progesterone level than pregnancy losses. The table below displays the prediction of favorable pregnancy outcomes.

Table 1

Overall, the study determines that progesterone level is directly correlated with favorable pregnancy outcome among patients undergoing Assisted Reproductive Technology. The way in which a woman conceives, whether it be IVF or IUI, may cause biased progesterone value to vary. The review represents the largest group of infertile patients analyzed for the predictive value of progesterone on pregnancy outcomes.

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