Serum Oestrogen and Progesterone Levels in the Early Luteal Phase as Predictors of Successful In-vitro Fertilisation Outcome: A Prospective Cohort Study

Abstract

Introduction: The serum levels of oestrogen and progesterone in the luteal phase of In-vitro Fertilisation (IVF) cycles using the long agonist protocol may play a role in predicting the outcome of the cycle. Aim: To determine the levels of oestrogen and progesterone in the early luteal phase of IVF cycles and their association with the pregnancy rate. Materials and Methods: A prospective cohort study was conducted in the IVF centre at Maulana Azad Medical College, Delhi, India, from September 2014 to August 2016. A total of 150 women undergoing IVF were recruited over a period of two years and underwent IVF using the standard long agonist protocol. Luteal phase support was provided according to the Institutional protocol. Blood samples were collected on the day of Ovum Pick Up (OPU) (day 0), the day of embryo transfer (day 3), the day of implantation (day 6), and the day of confirmation of biochemical pregnancy (day 17) to estimate serum Estradiol (E2) and Progesterone (P) levels. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 16.0, and a p-value <0.05 was considered significant. Results: The mean age of patients in the study was 31.17±1.09 years, and the mean duration of infertility was 8.2±4.2 years. Serum E2 (day 6, 1403.23±376.67 vs 1258.98±354.31 pg/mL; p=0.02) as well as P4 levels (day 6, 77.82±21.82 vs 68.90±22.17 pg/mL; p=0.01) were significantly higher on the day of implantation and day of confirmation of biochemical pregnancy (day 17, E2 541.80±498.01 vs 289.34±171.94 pg/mL, p<0.001; P4 70.61±121.47 vs 36.17±16.63 pg/mL, p<0.001) among those who conceived compared to those who did not conceive. Conclusion: Serum E2 and P4 levels in the luteal phase may help guide luteal phase support and serve as predictors of a successful cycle outcome in women undergoing IVF using the long agonist protocol.