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Fertil Steril. 2017 Mar;107(3):671-676.e2. doi: 10.1016/j.fertnstert.2016.11.019. Epub 2017 Jan 6.

Revisiting the progesterone to oocyte ratio.

Author information

1
Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: hillmicah@mail.nih.gov.
2
Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
3
Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
4
Division of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts.

Abstract

OBJECTIVE:

To critically evaluate the P to oocyte (O) ratio (P/O) in the prediction of live birth in assisted reproductive technology (ART) cycles.

DESIGN:

Retrospective cohort study.

SETTING:

Not applicable.

PATIENT(S):

A total of 7,608 fresh autologous ART ET cycles.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Live birth.

RESULT(S):

Generalized estimating equation (GEE) models and receiver operating characteristic curves assessed the ability of P, O, and the P/O ratio to predict live birth. In univariate GEE models, P, O, and P/O were each associated with live birth. However, in multivariate GEE models, the P/O ratio was not associated with live birth, but P alone was. This suggested that converting P and O into a ratio of P/O was not more helpful than the two independent variables themselves. Measures of overall model fit further suggested that P/O did not increase the predictive ability of the model over P and O alone. Receiver operating characteristic curves using incremental predictors further demonstrated that the P/O provided no incremental improvement in predicting live birth over P and O separately.

CONCLUSION(S):

These data suggest that P and O have utility in prediction modeling but demonstrate that additional oocytes were not protective from the negative association of P with live birth. There was no incremental improvement related to the P/O ratio specifically for predicting live birth over each variable independently.

KEYWORDS:

ART; premature progesterone elevation; progesterone; progesterone to oocyte ratio

PMID:
28069176
PMCID:
PMC5337440
DOI:
10.1016/j.fertnstert.2016.11.019
[Indexed for MEDLINE]
Free PMC Article

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