The effect of late-follicular phase progesterone elevation on embryo ploidy and cumulative live birth rates

Neves, Ana Raquel; Santos-Ribeiro, Samuel; García-Martínez, Sandra; Devesa, Marta; Soares, Sérgio Reis; García-Velasco, Juan A.; Garrido, Nicolás; Polyzos, Nikolaos P.

doi:10.1016/j.rbmo.2021.07.019

Cited by 11 publications

(12 citation statements)

References 43 publications

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“…Specifically, those with elevated serum progesterone levels during oocyte retrieval cycles who underwent frozen ET, and the recipients who received donor oocytes from donor cycles with elevated serum progesterone levels, had similar, if not increased, rates of implantation, deliveries per transfer, pregnancy, and ongoing pregnancy, and similar miscarriage rates [79,[82][83][84]. Additionally, there was no difference in cumulative live birth rates, i.e., the number of live-born deliveries from one ART cycle, between those with elevated vs. normal progesterone levels that underwent frozen embryo transfers and PGT-A [87]. In the studies investigating fresh ET, there were decreased, if not similar, rates of pregnancy and ongoing pregnancy, and live birth rates [44,88].…”

Section: Clinical Outcomementioning

confidence: 99%

“…The impact of premature progesterone elevation on the fertilization potential of retrieved oocytes was analyzed in OS cycles resulting in IVF with frozen and fresh ET cycles. Again, those with premature progesterone elevation exhibited similar or increased fertilization rates and a similar number of euploid embryos, embryos transferred, and embryos cryopreserved [27,79,80,[82][83][84][85][86][87]. To better understand the impact of premature progesterone elevation on the quality of these embryos, various embryo development rates were analyzed.…”

Section: Oocyte and Embryo Qualitymentioning

confidence: 99%

“…To better understand the impact of premature progesterone elevation on the quality of these embryos, various embryo development rates were analyzed. No differences were observed in the duration of embryo culture, cleavage rate, or blastocyst rate, when cycles with and without premature progesterone elevation were compared [27,42,43,82,83,85,87,88] When investigating embryo ploidy rates, Neves et al [87] conducted a multicenter retrospective study of 1495 IVF cycles with ICSI that underwent preimplantation genetic testing for aneuploidy (PGT-A). A GNRH antagonist protocol (recombinant FSH, hMG) for OS was used, followed by an hCG trigger for oocyte maturation.…”

Section: Oocyte and Embryo Qualitymentioning

confidence: 99%

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Towards an Improved Understanding of the Effects of Elevated Progesterone Levels on Human Endometrial Receptivity and Oocyte/Embryo Quality during Assisted Reproductive Technologies

Kalakota

George

Morelli

et al. 2022

Cells

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Ovarian stimulation is an indispensable part of IVF and is employed to produce multiple ovarian follicles. In women who undergo ovarian stimulation with gonadotropins, supraphysiological levels of estradiol, as well as a premature rise in progesterone levels, can be seen on the day of hCG administration. These alterations in hormone levels are associated with reduced embryo implantation and pregnancy rates in IVF cycles with a fresh embryo transfer. This article aims to improve the reader’s understanding of the effects of elevated progesterone levels on human endometrial receptivity and oocyte/embryo quality. Based on current clinical data, it appears that the premature rise in progesterone levels exerts minimal or no effects on oocyte/embryo quality, while advancing the histological development of the secretory endometrium and displacing the window of implantation. These clinical findings strongly suggest that reduced implantation and pregnancy rates are the result of a negatively affected endometrium rather than poor oocyte/embryo quality. Understanding the potential negative impact of elevated progesterone levels on the endometrium is crucial to improving implantation rates following a fresh embryo transfer. Clinical studies conducted over the past three decades, many of which have been reviewed here, have greatly advanced our knowledge in this important area.

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Section: Clinical Outcomementioning

confidence: 99%

Section: Oocyte and Embryo Qualitymentioning

confidence: 99%

Section: Oocyte and Embryo Qualitymentioning

confidence: 99%

See 1 more Smart Citation

Towards an Improved Understanding of the Effects of Elevated Progesterone Levels on Human Endometrial Receptivity and Oocyte/Embryo Quality during Assisted Reproductive Technologies

Kalakota

George

Morelli

et al. 2022

Cells

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“…[ 44 ] In few other studies, euploidy rate after preimplantation genetic testing (PGT) was similar in women with elevated P and LBR following transfer of such euploid embryos in FET cycles were not different. [ 45 46 47 48 ]…”

Section: P Remature P Rogesterone ...mentioning

confidence: 99%

“…[ 42 43 44 47 54 57 ] The euploidy rate after PGT-A was also similar in most studies. [ 45 46 47 48 ]…”

Section: E Levated P Rogesterone and ...mentioning

confidence: 99%

Premature Progesterone Elevation in in vitro Fertilisation Cycles – Current Perspectives

Gurunath

2022

Journal of Human Reproductive Sciences

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The impact of premature elevation of progesterone (PPE) on the day of the trigger on pregnancy outcome in in vitro fertilisation (IVF) cycles has been a matter of contention and debate for decades. Research over the last 30 years has indicated that PPE >1.5 ng/ml is associated with declining live birth rates following fresh embryo transfer. Freeze-only approach has become a universal solution to overcome the issue of PPE. However, the topic is still mired with controversy. Few studies have not shown a negative impact on pregnancy rates. The impact of PPE on embryological parameters such as oocyte and embryo quality and ploidy is still very controversial. An important contentious issue is the choice of the threshold P value above which it is considered abnormal and a freeze-all strategy would be cost-effective. Currently, though a cutoff of >1.5 ng/ml is widely used, practices are not uniform and varying thresholds from 0.4 to 3 ng/ml are utilised. This review addresses the current understanding of PPE in IVF and the above controversies. The incidence, aetiology and source of progesterone rise, impact on endometrial receptivity, oocyte and embryo quality, impact on live birth and cumulative live birth and impact on frozen embryo transfer and donor oocyte cycles are discussed. Current controversies regarding the optimal threshold, assay performance and future directions are addressed.

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Delayed blastocyst development is influenced by the level of progesterone on the day of trigger

Villanacci

Buzzaccarini

Marzanati

et al. 2022

J Assist Reprod Genet

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The effect of late-follicular phase progesterone elevation on embryo ploidy and cumulative live birth rates

Cited by 11 publications

References 43 publications

Towards an Improved Understanding of the Effects of Elevated Progesterone Levels on Human Endometrial Receptivity and Oocyte/Embryo Quality during Assisted Reproductive Technologies

Towards an Improved Understanding of the Effects of Elevated Progesterone Levels on Human Endometrial Receptivity and Oocyte/Embryo Quality during Assisted Reproductive Technologies

Premature Progesterone Elevation in in vitro Fertilisation Cycles – Current Perspectives

Delayed blastocyst development is influenced by the level of progesterone on the day of trigger

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