Effect of slightly elevated progesterone on hCG trigger day on clinical pregnancy rate in GnRH-ant IVF/ICSI cycles

Zhao, Jing; Hao, Jie; Xu, Bin; Wang, Yonggang; Li, Yanping

doi:10.1186/s12978-022-01371-4

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…4 ). A previous study revealed that CPR with progesterone less than 1.0 ng/mL was significantly higher than progesterone with 1.0 to 1.5 ng/mL [ 20 ], while another study showed significantly lower CPR with less than 0.5 ng/mL [ 18 ]. Meanwhile, progesterone was a dynamic parameter during the process of assisted reproduction, which increasing from the day of oocyte pick-up to the day 3 of embryo culture [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of clinical and laboratory parameters on clinical pregnancy and live birth rates in fresh cycles: a retrospective study of 9608 high-quality cleavage-stage embryos

Zhao,

Gan,

et al. 2024

J Ovarian Res

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Background Evidence from the Istanbul consensus workshop suggests correlations between morphological parameters and embryo developments. 8-cell embryos are the best blastomere stage on day 3. No good quality evidence exists to support high-quality embryonic selection following blastulation and clinical outcomes. This study aimed to investigate the factors that affect blastocyst formation, blastocyst quality, and clinical outcomes of high-quality cleavage-stage embryos in fresh cycles. Methods This study was a retrospective analysis of 9608 high-quality cleavage-stage embryos from 2987 couples between January 2017 to June 2021, namely 1520 embryos categorized as “812” (8-cell, grade 2, mild fragmentation), 2961 as “821” (8-cell, grade 2, mild asymmetry), 896 as “711” (7-cell, grade 1), and 517 as “911” (9-cell, grade 1) compared with 3714 embryos categorized as “811” (8-cell, grade 1). The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Blastulation rate (BR), available late blastocyst rate (ABR) and high-quality late blastocyst rate (HBR) were secondary outcome measures. Results BR, ABR, and HBR had significant differences among the five groups (P < 0.001), while CPR and LBR were also significantly different in cleavage-stage fresh transfer (P < 0.01). The multivariable multilevel logistic regression analysis revealed a significant association between cell number, cell size, blastocyst development and clinical outcomes. For 7 to 9-cell highest-quality embryo, mild fragmentation and more blastomeres were more conducive to blastocyst formation and clinical outcomes. While cleavage-stage embryos developed into blastocysts, the negative impact of their initial morphology on clinical outcomes would be erased. Conclusions Our study firstly evaluated blastocyst development and clinical outcomes of high-quality cleavage-stage embryos in fresh cycles, with rankings of 811, 812, 911, 821, and 711. We found the initial morphological characteristics of the high-quality cleavage-stage embryos did not adversely impact clinical outcomes, even as they progressed to the blastocyst stage.

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Section: Discussionmentioning

confidence: 99%

The impact of clinical and laboratory parameters on clinical pregnancy and live birth rates in fresh cycles: a retrospective study of 9608 high-quality cleavage-stage embryos

Zhao,

Gan,

et al. 2024

J Ovarian Res

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“…( 32 ) set the limit of the hCG daily P level to 1.5 ng/ml, which is widely used in clinical practice. However, studies show that when P>1 ng/ml, the CPR or LBR decreases ( 13 , 19 , 23 ). Only people with normal ovarian response with GnRH antagonist protocols were included for analysis in our study, and P>1 ng/ml affected the LBR of fresh embryo transfer.…”

Section: Discussionmentioning

confidence: 99%

“…We divided all cycles into 2 groups by the P level on the day of hCG trigger, P<1.0 ng/ml and P≥1.0 ng/ml. This grouping was primarily based on data distribution characteristics and reference to current related research ( 13 , 22 , 23 ).…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, the effect of elevated P levels on clinical outcomes may vary in different ovarian responders. Due to differences in populations, races, protocols, etc., the currently reported elevated P values are not uniform (13,19,20).…”

Section: Introductionmentioning

confidence: 91%

“…Optimization of the LBR of fresh embryo transfer with GnRH antagonist protocols is the focus of much research. Serum progesterone (P) level is an important indicator in the pregnancy rate of the fresh cycle, and elevated P levels on the day of human chorionic gonadotropin (hCG) administration negatively influence clinical outcomes (12)(13)(14). Many studies examined the effect of serum P on clinical outcomes by measuring serum P levels on the day of the hCG trigger.…”

Section: Introductionmentioning

confidence: 99%

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Effect of serum progesterone levels on hCG trigger day on pregnancy outcomes in GnRH antagonist cycles

Zhang

Du²,

Wu³

et al. 2022

Front. Endocrinol.

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ObjectiveThe present study analyzed the effect of hCG trigger day progesterone (P) levels on the live birth rate (LBR) in the gonadotropin-releasing hormone (GnRH) antagonist protocol.Materials and methodsThis study was a single-center retrospective study. In vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles performed from January 2017 to December 2020 were included in the analysis. This study included people with a normal ovarian response to fresh embryo transfer of GnRH antagonist protocols. All cycles were divided into 2 groups by P level on the day of human chorionic gonadotropin (hCG) trigger, P<1.0 ng/ml and P≥1.0 ng/ml. The primary outcome measure was LBR.ResultA total of 867 cycles with P<1.0 ng/ml and 362 cycles with P≥1.0 ng/ml were included in the analysis. The clinical pregnancy rate (CPR) was higher in the P<1.0 ng/ml group than the P≥1.0 ng/ml group (44.9% vs. 37.6%, P=0.02). The early spontaneous abortion rate was comparable between the groups (14.4% vs. 14.7%, P=0.93). For live birth, the rate for the P<1.0 ng/ml group was 35.3%, which was significantly higher than the 29.0% in the P≥1.0 ng/ml group (P=0.03). After binary logistic regression analysis, the P level on the hCG trigger day (adjusted odds ratio=0.74, 95% CI=0.55-0.99, P=0.04) was an independent risk factor for LBR. For the P level on the hCG trigger day, the LBR was lower in the P≥1.0 ng/ml group compared to the P<1.0 ng/ml group.ConclusionFor normal ovarian response patients using the GnRH antagonist protocol, serum P≥1.0 ng/ml on the hCG trigger day resulted in a lower LBR than the P<1.0 ng/ml group. When P≥1.0 ng/ml, whole embryo freezing may be considered.

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Predictive strategies for oocyte maturation in IVF cycles: from single indicators to integrated models

He,

Xu,

Lin

et al. 2024

Middle East Fertil Soc J

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Accurate prediction of oocyte maturation is a critical determinant of success in in vitro fertilization-embryo transfer (IVF-ET) procedures. This review provides a comprehensive analysis of the various predictive approaches employed to assess oocyte maturity, including single indicators, combined indicators, and predictive models. Factors such as ovarian reserve, patient characteristics, and controlled ovarian hyperstimulation (COH) strategies can significantly influence oocyte maturation rates. Single indicators, including hormone levels, ultrasound parameters, and clinical parameters, have been extensively studied. However, their predictive power may be limited when used in isolation. Combined indicators, integrating multiple parameters, have demonstrated improved predictive performance compared to single indicators. Additionally, predictive models and algorithms, such as machine learning and deep learning models, have emerged as promising tools for assessing oocyte maturity. These models leverage advanced statistical and computational methods to analyze complex datasets and identify patterns that can predict oocyte maturation rates with potentially higher accuracy. Despite these advancements, several gaps and limitations persist, including limited generalizability, lack of standardization, insufficient external validation, and the need to incorporate patient-specific factors and emerging technologies. The review highlights potential areas for further research, such as multicenter collaborative studies, integration of advanced omics technologies, development of personalized prediction models, and investigation of trigger time optimization strategies. Recommendations for clinical practice include utilizing a combination of indicators, adopting validated predictive models, tailoring approaches based on individual patient characteristics, continuous monitoring and adjustment, and fostering multidisciplinary collaboration. Accurate prediction of oocyte maturation holds profound implications for improving the success rates of IVF-ET and enhancing the chances of achieving a healthy pregnancy. Continued research, innovative approaches, and the implementation of evidence-based practices are essential to optimize assisted reproductive outcomes.

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Effect of slightly elevated progesterone on hCG trigger day on clinical pregnancy rate in GnRH-ant IVF/ICSI cycles

Cited by 5 publications

References 27 publications

The impact of clinical and laboratory parameters on clinical pregnancy and live birth rates in fresh cycles: a retrospective study of 9608 high-quality cleavage-stage embryos

The impact of clinical and laboratory parameters on clinical pregnancy and live birth rates in fresh cycles: a retrospective study of 9608 high-quality cleavage-stage embryos

Effect of serum progesterone levels on hCG trigger day on pregnancy outcomes in GnRH antagonist cycles

Predictive strategies for oocyte maturation in IVF cycles: from single indicators to integrated models

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