The prognostic value of serum concentrations of progesterone, estradiol, and luteinizing hormone during superovulation with and without adjunctive leuprolide therapy

Objective: To determine the predictive value of preovulatory serum concentrations of P, E₂, and LH for pregnancy achieved with IUI after superovulation with and without adjunctive leuprolide acetate (LA) therapy. Design: Randomized, crossover study of superovulation with and without LA therapy. Setting: Infertility clinic. Patients: Subfertile patients referred for superovulation and IUI. Main Outcome Measures: Preovulatory serum concentrations of P, E₂, and LH on the day of hCG administration; pregnancy. Results: Preovulatory serum concentrations of P, E₂, and LH had equivalent predictive value for pregnancy during cycles stimulated without LA therapy. No single parameter was particularly useful in clinical decision making. Threshold P concentrations proposed in other studies as useful in predicting pregnancy did not correlate with cycle fecundity. The predictive value of preovulatory concentrations of P during superovulation with adjunctive LA therapy was significantly worse than P concentrations during superovulation without LA therapy. Conclusions: Preovulatory serum P, E₂, and LH concentrations in superovulation and IUI are not helpful in determining prognosis for pregnancy. The relative utility of predictive parameters may vary for different treatment regimens.