Revisiting debates of premature luteinization and its effect on assisted reproductive technology outcome

Hussein, Reda S.; Elnashar, I.; Amin, Abu El-Eyuoon Abu Zied; Abou-Taleb, Hisham; Abbas, Ahmed M.; Abdelmageed, Ahmed M; Farghaly, Tarek; Zhao, Yulian

doi:10.1007/s10815-019-01598-4

Cited by 9 publications

(3 citation statements)

References 112 publications

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“…In particular, when serum P4 levels were > 1.75 ng/mL, the rates of GQE at the cleavage stage were significantly reduced. Some analyses have indicated that there is a significant association with a decreased probability of pregnancy during IVF cycles with detrimental endometrial receptivity under a serum P4 threshold > 1.5 ng/mL [ 17 , 18 , 19 ]. However, the clinical criteria for increased P4 levels are highly dependent on individual clinics [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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

Woo

Kwon

Choi

et al. 2022

JCM

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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.

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Section: Discussionmentioning

confidence: 99%

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

Woo

Kwon

Choi

et al. 2022

JCM

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“…Since the first report of premature progesterone rise (PPR) during the late follicular phase in 1991, there has been considerable interest in the past 30 years [ 1 ]. PPR is generally defined as serum progesterone ≥ 1.2 ng/mL or ≥1.5 ng/mL on the day of the hCG trigger in controlled ovarian stimulation cycles [ 2 , 3 , 4 ]. This phenomenon is relatively common in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) procedures, with an incidence rate of approximately 17–29% [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Premature Progesterone Rise Is Associated with Higher Cumulative Live Birth Rate with Freeze-All Strategy

Wang,

Chen,

Guu

et al. 2024

JCM

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Background/Objectives: This paper undertakes an investigation into the implications of premature progesterone rise (PPR) on pregnancy outcomes in freeze-all strategy cycles. Methods: A retrospective cohort study encompassing 675 IVF/ICSI cycles using a freeze-all strategy was enrolled. The cycles were categorized into two groups based on serum progesterone levels at the time of hCG administration: 526 cycles had levels below 1.5 ng/mL, while 149 cycles had levels equal to or above 1.5 ng/mL. Results: The findings revealed a significantly higher number of mature follicles and retrieved oocytes in patients with PPR across all AMH categories. Multiple analyses revealed factors influencing PPR, including the duration of induction and the number of retrieved oocytes. Within the same oocyte retrieval number group, patients with PPR demonstrated non-inferior pregnancy outcomes compared to non-PPR patients. Upon adjustment for age, AMH, and total follicle-stimulating hormone (FSH) dosage, PPR maintained a positive correlation with the cumulative live birth rate (LBR). Conclusions: The study showed that PPR correlates with an increase in retrieved oocytes while maintaining similar embryo quality and oocyte retrieval rates and results in a higher cumulative LBR.

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“…Premature luteinization is defined as an early elevation of circulating P4 in the late follicular phase, measured prior to or on the day of hCG trigger in women receiving ovarian stimulation for IVF (51,52). It often causes a cancellation of fresh embryo transfer due to the risks of altered endometrial receptivity and embryo-endometrial asynchrony, which result in lower implantation and pregnancy success (52)(53)(54)(55)(56). High doses of FSH have been postulated as a major reason for the high P4 secretion (57), but the underlying mechanisms remain unknown.…”

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confidence: 99%

Dose-response functional and transcriptomic effects of follicle-stimulating hormone onex vivomouse folliculogenesis

Zhan,

Zhang,

Zhang

et al. 2024

Preprint

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The gonadotropin-dependent phase of ovarian folliculogenesis primarily requires follicle-stimulating hormone (FSH) to support one or multiple antral follicles, dependent on the species, to mature fully, enabling ovarian steroidogenesis, oogenesis, and ovulation to sustain female reproductive cycles and fertility. FSH binds to its membrane receptor in granulosa cells to activate various signal transduction pathways and gene regulatory networks. Poor female reproductive outcomes can result from both FSH insufficiency owing to genetic or non-genetic factors and FSH excess as encountered with ovarian stimulation in assisted reproductive technology (ART), but the underlying molecular mechanisms remain elusive. Herein, we conducted single-follicle and single-oocyte RNA sequencing analysis along with other approaches in anex vivomouse folliculogenesis and oogenesis system to investigate the effects of different concentrations of FSH on key follicular events. Our study revealed that a minimum FSH threshold is required for follicle maturation into the high estradiol-secreting preovulatory stage, and the threshold is moderately variable among individual follicles. FSH at subthreshold, threshold, and suprathreshold levels induced distinct expression patterns of follicle maturation-related genes and the follicular transcriptomics. The RNA-seq analysis identified novel genes and signaling pathways that may critically regulate follicle maturation. Suprathreshold FSH resulted in multiple ovarian disorders including premature luteinization, high production of androgen and proinflammatory factors, and reduced expression of energy metabolism-related genes in oocytes. Together, this study improves our understanding of gonadotropin-dependent folliculogenesis and provides crucial insights into how high doses of FSH used in ART may impact follicular health, oocyte quality, pregnancy outcome, and systemic health.

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Revisiting debates of premature luteinization and its effect on assisted reproductive technology outcome

Cited by 9 publications

References 112 publications

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

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

Premature Progesterone Rise Is Associated with Higher Cumulative Live Birth Rate with Freeze-All Strategy

Dose-response functional and transcriptomic effects of follicle-stimulating hormone onex vivomouse folliculogenesis

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