Can serum progesterone leves be used to predict a success or a failure of an IVF treatment cycle?

The aim of this study is to determinate whether serum Progesterone level the day of the induction of the ovulation is a reliable marker to predict the likelihood of pregnancy in IVF / ICSI cycles. A retrospective study including 183 IVF and ICSI cycles performed at Quiron Bilbao, University associated Assisted Reproduction Center, was carried out. Oocyte donation cycles were not included in the study. We have studied 183 consecutive cycles of IVF / ICSI. A total of 65 ongoing pregnancies were achieved. We have studied the relationship between the mean levels of serum Progesterone in both of the groups (with and without pregnancy), and if there is a value of Progesterone that can predict a pregnancy. No significant differences were found in serum Progesterone levels in cycles in which a pregnancy was achieved compared to cycles without pregnancy (p 0,09). Moreover, there was not a cut-off value of serum Progesterone that could predict either a pregnancy or a failed cycle, by analyzing ROC curves. Furthermore, the division of Progesterone levels in cuartiles did not give different pregnancy rates. Taking the 50 percentile as a reference, the pregnancy rate does not differ in cycles with lower or higher value of serum Progesterone (38,9% Vs 31,6%; p 0,314). According to our study, the serum Progesterone level is not a faithful marker to predict a pregnancy, as its levels are not different between cycles with or without pregnancy, and cannot be correlated with the likelihood of a pregnancy. The proposed detrimental effect of high Progesterone levels on implantation and pregnancy rates is far from being an absolute and proven fact. Our results bring up on some recently published papers. Thus, a high level of serum Progesterone on day of ovulation triggering is not enough to discontinue the treatment.