Premature luteinization in controlled ovarian hyperstimulation has no adverse effect on oocyte and embryo quality

Risk of premature luteinization in IVF cycles and its impact on clinical pregnancy rate

“…5,6,[12][13][14] Which exclude the effect of PL on oocyte quality, as previously suggested. 1,3,5 However a progesterone rise during the late follicular phase has been considered a negative predictive factor for clinical outcome in both GnRH agonist, Schoolcraft [20][21][22][23][24][25] Although several authors did not find any negative effect of PL on IVF outcome. 4,6,7,9 There is a marked variation in the incidence of PL, 13% to 71% due to discrepancies in definition, population characteristics and/or treatment protocols.…”

“…[1][2][3][4] Most studies used an absolute P4 level on the day of HCG administration as an indicator of PL, and the cut off level differed from 0.8 to 2ng/ml. 2,[5][6][7][8][9] The cutoff of 1.5 ng/ml cannot be considered arbitrary, as it signifies the transition from the follicular phase to the luteal phase in the natural cycle (Hoff et al 1983). 10 Serum P4 concentration increase gradually 12-24 hrs before the onset of the LH surge.…”

“…4,6,7,9 There is a marked variation in the incidence of PL, 13% to 71% due to discrepancies in definition, population characteristics and/or treatment protocols. 2,[5][6][7][8][9] The pathogenesis of PL in COH is still poorly understood. Increased LH receptor sensitivity of the granulosa cells to FSH especially in hyper responders is one of the important hypothesis of PL Elnashar et al 17 The use of GnRH antagonist is increasing day by day in IVF cycles.…”

Progesterone levels on the hCG day and outcomes in vitro fertilization in women with polycystic ovary syndrome

“…High P levels have been shown to adversely affect embryo quality and pregnancy rates in IVF and oocyte donation programs [23]. In one study, premature luteinization during COH had no adverse effect on oocyte and embryo quality [24], while others have reported that premature luteinization during GnRH antagonist IVF-embryo transfer cycles was frequently observed and associated with lower pregnancy and implantation rates [3]. In the present study, in the only PCOS patients with excluding no PCOS patients, a serum P level of ≥1.2 ng/ mL on the day of hCG was defined as the break point for premature luteinization.…”

Gene Expression and Premature Progesterone Rise

“…In these articles, 0.9 ng/ml was found as the lowest threshold for P concentration and 1.5 ng/ml was found as the highest threshold. Although different cut-offs have been used over the years ranging from 0.8 to even 2 ng/ml (Hofmann et al, 1993;Ubaldi et al, 1996;Silverberg et al, 1994;Edelstein et al, 1990;Givens et al, 1994), in recent publications the upper cut-off level is set at 1.5 ng/ml.…”