Objective: To determine whether an elevated serum P:E2 ratio on the day of hCG administration during gonadotropin stimulation for intrauterine insemination (IUI) or IVF is associated with diminished ovarian reserve.
Design: Retrospective chart review.
Setting: Tertiary fertility center.
Patient(s): Two hundred eighty-six women undergoing a fertility evaluation.
Intervention(s): Clomiphene citrate challenge test (CCCT).
Main outcome measure(s): E2 and P concentrations on the day of hCG administration.
Result(s): For the IUI group (n = 98), 74 women had a normal CCCT, while 24 had an abnormal CCCT. For women undergoing IVF (n = 188), 171 had a normal CCCT and 17 had an abnormal CCCT. For women undergoing IUI with a normal CCCT, 33 (44%) had a [(P/E2) x 1000] ratio <1 on the day of hCG, while 12 (50%) (abnormal CCCT) had a [(P/E2) x 1000] ratio <1. Similarly, for women doing IVF with a normal CCCT, 96 (56%) had a [(P/E2) x 1000] ratio <1 on the day of hCG, and 9 (44%) (abnormal CCCT) had a [(P/E2) x 1000] ratio <1 on the day of hCG. The frequencies were similar for all comparable groups. For both groups, there was no association between serum (P/E2) x 1000 on the day of hCG administration and day 3 or 10 FSH during the CCCT. For women with a normal CCCT, there were no differences in delivery rates based on the (P/E2) x 1000 ratio.
Conclusion(s): In women stimulated with hMG for IUI or IVF, the serum P:E2 ratio on the day of hCG administration is not associated with diminished ovarian reserve, as demonstrated by the CCCT, or pregnancy outcome.