AUTHOR=Thomsen Lise Haaber , Humaidan Peter , Erb Karin , Overgaard Martin , Andersen Claus Yding , Kesmodel Ulrik Schiøler 

TITLE=Mid-Luteal 17-OH Progesterone Levels in 614 Women Undergoing IVF-Treatment and Fresh Embryo Transfer—Daytime Variation and Impact on Live Birth Rates

JOURNAL=Frontiers in Endocrinology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2018.00690

DOI=10.3389/fendo.2018.00690

ISSN=1664-2392

ABSTRACT=<p><bold>Introduction:</bold> Corpus luteum (CL) produces progesterone (P<sub>4</sub>) and 17-OH progesterone (17-OH P<sub>4</sub>) during the luteal phase. Contrary to P<sub>4</sub>, 17-OH P<sub>4</sub> is not supplied as part of the luteal phase support following IVF-treatment. Therefore, measuring endogenous serum 17-OH P<sub>4</sub> levels may more accurately reflect the CL function compared to monitoring serum P<sub>4</sub> concentrations.</p><p><bold>Objective:</bold> To explore the correlation between mid-luteal serum 17-OH P<sub>4</sub> levels and live birth rates and to explore the possible daytime variations in mid-luteal serum 17-OH P<sub>4.</sub></p><p><bold>Design:</bold> Prospective cohort study.</p><p><bold>Patients:</bold> 614 women undergoing IVF-treatment and fresh embryo transfer.</p><p><bold>Intervention:</bold> All patients had serum 17-OH P<sub>4</sub> measured 7 days after oocyte pick-up (OPU+7). Furthermore, on OPU+7, seven patients underwent repeated blood sampling during daytime to clarify the endogenous daytime secretory pattern of 17-OH P<sub>4</sub>.</p><p><bold>Outcome measure:</bold> Live birth rate.</p><p><bold>Secondary outcome measure:</bold> Daytime variation in serum 17-OH P<sub>4</sub> levels.</p><p><bold>Results:</bold> The highest chance of a live birth was seen with mid-luteal 17-OH P<sub>4</sub> between 6.0 and 14.0 nmol/l. The chance of a live birth was reduced below (RD −10%, <italic>p</italic> = 0.07), but also above the optimal range for 17-OH P<sub>4</sub> (RD −12%, <italic>p</italic> = 0.04). Patients with diminished CL-function (17-OH P<sub>4</sub> &lt; 6 nmol/l) displayed clinically stable 17-OH P<sub>4</sub> values, whereas patients with 17-OH P<sub>4</sub> levels &gt;6 nmol/l showed random 17-OH P<sub>4</sub> fluctuations during daytime.</p><p><bold>Conclusion:</bold> The association between 17-OH P<sub>4</sub> and reproductive outcomes is non-linear, and the negative effect of excessive CL-secretion seems to be just as strong as the negative effect of a reduced CL-function during the peri-implantation period.</p>