Effects of Elevated Progesterone Levels on the Day of hCG on the Quality of Oocyte and Embryo

Abstract

This study is designed to investigate the effects of increased progesterone (P4) levels on the quality of retrieved oocytes and embryos during IVF. This retrospective analysis included 982 all-freezing in vitro fertilization (IVF) cycles (conducted between November 2019 and June 2020 at CHA Fertility Center Bundang, South Korea) in which serum P4 levels were measured on the day of human chorionic gonadotropin (hCG) administration. Our study revealed that the serum P4 levels on the day of hCG administration are strongly associated with the rates of oocyte maturation, displaying a positive correlation in patients with serum P4 < 2.25 ng/mL (p = 0.025). Moreover, patients with serum P4 < 1.25 ng/mL showed relatively low fertilization rates (p = 0.037), and the rates of good embryo retrieval were significantly increased with the serum P4 level < 1.5 ng/mL (p = 0.001). Interestingly, serum P4 level on the day of hCG administration affects the rate of good-quality embryo development, especially at the cleavage stage, and is associated with the status of ovarian responses. Our current study suggests that serum P4 level on the day of hCG administration negatively affects the rates of oocyte maturation, fertilization, and the development of good embryos.

Effect of High Progesterone Level on Day of Human Chrionic Gonadotropin Triggering on Pregnancy Rate in Frozen Embryo Transfer

“…However, a retrospective analysis by Woo et al (24) indicated found the maturity rates of oocytes were significantly higher in patients with high blood P4 levels, and that the maturation rates were inversely correlated with hcg-P4 levels. The study, which used 982 completely frozen IVF procedures (IVF) cycles employing GnRh antagonist down regulation.…”

Premature Progesterone Elevation in in vitro Fertilisation Cycles – Current Perspectives

“…Ten studies have been published evaluating the impact of PPE on oocyte and embryo quality since the systematic review of Venetis et al . [ 6 42 43 44 47 53 54 55 56 57 ] [ Table 2 ]. They are all retrospective cohort studies using a P threshold of 1.5–2.0 ng/ml.…”

“…Four studies found PPE to be associated with a lower number of top-quality blastocysts. [ 6 53 55 56 ] They proposed that delaying the trigger with an intention to retrieve greater oocyte numbers may cause elevated P and a lower number of utilisable blastocysts; which in turn would reduce CLBR. However, the remaining six studies indicated a similar number of top-quality embryos in both groups with no obvious detrimental effect of PPE on oocyte and embryo quality.…”