Elevated progesterone during ovarian stimulation for IVF

Abstract

There is an ongoing debate regarding the impact of premature progesterone rise on the IVF outcome. The objective of this review is to assess evidence of poorer ongoing pregnancy rate in IVF cycles with elevated serum progesterone at the end of follicular phase in ovarian stimulation. It also explores the origin of the progesterone rise, potential modifying factors and possible methods to prevent its rise during ovarian stimulation. This review draws on information already published from monitoring progesterone concentrations at the end of follicular phase in ovarian stimulation. The databases of Medline and PubMed were searched to identify relevant publications. Good-quality evidence supports the negative impact on endometrial receptivity of elevated progesterone concentrations at the end of the follicular phase in ovarian stimulation. Future trials should document the cause and origin of premature progesterone in stimulated IVF cycles. There is an ongoing debate regarding the impact of premature progesterone rise on the IVF outcome. The objective of this review is to assess evidence of poorer ongoing pregnancy rate in IVF cycles with elevated serum progesterone at the end of follicular phase in ovarian stimulation. It also explores the origin of the progesterone rise, potential modifying factors and possible methods to prevent its rise during ovarian stimulation. This review draws on information already published from monitoring progesterone concentrations at the end of follicular phase in ovarian stimulation. The databases of Medline and PubMed were searched to identify relevant publications. Good-quality evidence supports the negative impact on endometrial receptivity of elevated progesterone concentrations at the end of follicular phase in ovarian stimulation. Future trials should document the cause and origin of premature progesterone in stimulated IVF cycles.

Reproductive outcome is optimized by genomic embryo screening, vitrification, and subsequent transfer into a prepared synchronous endometrium

“…Premature elevations in progesterone concentration have been associated with adverse IVF outcomes [25][26][27][28]. Yet, recent studies stress the importance of the timing of the window of implantation as much as its duration.…”

Perinatal outcomes after fresh versus vitrified-warmed blastocyst transfer: retrospective analysis

“…The early luteal phase is critical to pregnancy, as it governs embryo implantation and placentation (3,14). The elucidation of the cause and effect relationship between COS and pregnancy outcomes has, therefore, been the key objective of a number of studies, each with a different approach (7,(15)(16)(17)(18)(19)(20).…”

Vitrification of Human Oocytes and its Contribution to In Vitro Fertilization Programs

“…This is probably due to the fact that these patients have increased levels of estrogen and progesterone during and after the superovulation. Clinical studies indicate that high levels of estrogen are correlated with early progesterone peaks, even before hCG is administered to trigger the ovulation (Kyrou et al, 2009;Bosch et al, 2010;Kolibianakis et al, 2012;Al-Azemi et al, 2012). High levels of progesterone have been associated with the early secretion stage in human endometrium and a drop in pregnancy rates (Weineman & Mainigi, 2014 Ruiz-Alonso et al, 2013).…”