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Korean Journal of Obstetrics & Gynecology 2000;43(2):281-285.
Published online January 1, 2001.
Blastulation and the clinical outcome of the blastocyst transfer in the COH cycles with premature progesterone elevation.
Sun Haeng Kim, Yong Ho Lee, Nak Woo Lee, Tak Kim
Abstract
OBJECTIVES
To determine the effect of increased plasma Progesterone(P) level on the day of hCG administration on oocyte /embryo development and implantation after blastocyst transfer in controlled ovarian hyperstimulation (COH) cycle with premature progesterone elevation for IVF-ET. METHODS: Seventy controlled ovarian hyperstimulation cycles for IVF-ET were underwent with GnRH agonist and hMG/FSH in 70 women. Embryos were cocultured up to the blastocyst stage and transferred into the uterine cavity. The cycles were devided into two groups depending on the levels of plasma P on the day of hCG administration, and the clinical results in both groups were analysed and compared each other. High P group was defined when the level of plasma P was higher than 0.9 ng/mL. RESULTS: Fertilization rates, cleavage rates and blastulation rates were similar in the low and high P groups. Blastulation rates were increased in high quality (morphological characteristics) D 2-3 preembryo regardless of the P levels during the late follicular phase(p <0.001). However, clinical pregnancy rate, ongoing pregnancy rate and implantation rate were higher in low P group compared with high P group(p <0.01). CONCLUSIONS: Premature P elevation did not deteriorate the developmental potential of oocyte, but had a harmful effect on pregnancy rate and implantation rate. So we suggest that early ET on the day 2-3 (after ovum pick-up) without delaying another several days to avoid the advanced maturation of secretory endometrium might be better than blastocyst transfer in patients with premature P elevation.
Key Words: COH for IVF-ET, premature progesterone elevation, blastocyst transfer, clinical outcome


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