Human Reproduction, Vol. 14, No. 3, 601-605,
March 1999
© 1999 European Society of Human Reproduction and Embryology
Elevated serum progesterone on the day of HCG administration in IVF is associated with a higher pregnancy rate in polycystic ovary syndrome
1 Department of Obstetrics and Gynecology, University of Milan, H.San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milano and 2 Department of Physiology, University of Brescia, Via Valsabbina 29, Brescia, Italy
Our study compared 84 patients with polycystic ovary syndrome (PCOS) with 84 control patients who had normal ovaries and who were matched for the main determinants of success in in-vitro fertilization (IVF) and embryo transfer. Serum concentrations of oestradiol and progesterone on the day of human chorionic gonadotrophin (HCG) injection were significantly higher in PCOS than in normal patients (oestradiol 2016 ± 1.8 pg/ml versus 1456 ± 40.9 pg/ml, P < 0.01; progesterone 1.6 ± 0.1 ng/ml versus 1.2 ± 0.1 ng/ml, P = 0.03). Furthermore despite oocytes from PCOS patients having a reduced fertilization rate compared with normal patients (61.8 ± 4.1% versus 73.5 ± 4.3%, P = 0.03), the differences in pregnancy rate (22.6 versus 19%) and miscarriage (31.5 versus 18.7%) were not statistically significant. In PCOS patients, a critical breakpoint was identified at serum progesterone concentrations of 1.2 ng/ml on the day of HCG injection. The PCOS patients with progesterone 
ISOdia1.2 ng/ml showed a higher pregnancy and miscarriage rate than PCOS patients with progesterone <1.2 ng/ml (26.6 versus 17.9%, P < 0.01; and 41.7% versus 14.3%, P < 0.01 respectively). These findings suggest that premature progesterone production does not have an adverse effect on pregnancy rate in PCOS, but on the contrary, may be a predictor for success in IVF/embryo transfer.
Key words: in-vitro fertilization/oestradiol/polycystic ovary syndrome/progesterone
3 To whom correspondence should be addressed
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