The Effect of Progesterone Levels on Pregnancy

Ovarian stimulation with gonadotropins is a frequently used method in patients with unexplained infertility undergoing intrauterine insemination.

Pregnancy and live birth rates after ovarian stimulation; The number of follicles in ovulatory size and responsive to ovarian stimulation is affected by many factors such as the age of the woman and the duration of infertility. Progesterone production in the luteal phase is necessary to achieve successful treatment results by increasing the receptivity of the endometrium in the secretory phase.

In assisted reproductive techniques, exogenous progesterone support in the luteal phase is a routinely used method due to higher pregnancy rates, but there is no consensus with the use of progesterone in IUI applications. In a recent meta-analysis, a positive relationship was found between gonadotropins and progesterone support when ovulation induction and intrauterine insemination were performed, while this relationship was not found with clomiphene citrate, and although letrozole and gonadotropin were used together, no significant statistics were found.

The relationship between luteal phase hormone dynamics and pregnancy outcomes in IUI is not fully understood. Although luteal phase failure is mentioned, there is no accepted definition of luteal phase failure worldwide. In one study, progesterone concentrations in the midluteal phase and pregnancy outcomes were investigated in 188 IUI cycles, predicting that low levels could predict treatment failure. In another study, a positive relationship was found between luteal phase progesterone levels and clinical pregnancy outcomes.However, the relationship between blood progesterone levels and pregnancy rates in a small number of IUI cycles has been investigated in the literature. Considering all these studies, there is no Level 1 evidence regarding the benefit of providing progesterone support in groups where the progesterone level is below a certain threshold value. In this study, we aimed to investigate the relationship between gestational outcomes by looking at progesterone values on the 3rd and 5th days after IUI in patients who were decided to be treated with IUI. By looking at these progesterone levels, we aimed to determine a threshold value for the ideal level of progesterone in the luteal phase and to be a guide in terms of possible results and methods of shaping the treatment.