Preovulatory progesterone concentration associates significantly to follicle number and LH concentration but not to pregnancy rate

Ruiz

et al. 2014

Reprod Biol Endocrinol

BackgroundLuteinizing hormone (LH) activity in human menopausal gonadotropin (hMG) preparations is derived from human chorionic gonadotropin (hCG) rather than LH. Therefore, we aimed to determine whether there are similarities in the endocrine and follicular profiles of serum and follicular fluid from controlled ovarian stimulation with the recombinant gonadotropins follicle-stimulating hormone plus luteinizing hormone (rFSH + rLH) or highly purified human menopausal gonadotropin (HP-hMG).MethodsWe performed a prospective observational study with 50 oocyte donors that received either a combination of recombinant gonadotropins (rFSH + rLH) or a mixture of urinary gonadotropins (HP-hMG) plus purified urinary FSH (uFSH). Results were analyzed using Student’s t-test to compare continuous variables and the chi-squared test to compare proportions. P-values < 0.05 were considered statistically significant.ResultsAlthough more oocytes were retrieved after treatment with recombinant than urinary gonadotropins (16.5 vs. 11.8; P = 0.049), a higher proportion of metaphase II ova (71.2% vs. 80.6%; P = 0.003) were obtained using urinary gonadotropins. On day 6 and on the day of triggering, serum steroid hormone levels were slightly but not significantly elevated in the recombinant group compared with the urinary group. In follicular fluid, no statistical differences were observed for intra-follicular levels of steroid hormones between the two protocols; ongoing pregnancy rates were similar (46.1% vs. 46.1%).ConclusionsOur data suggest that endocrinological and follicular profiles do not differ between rFSH + rLH and HP-hMG stimulation.

Section: Discussionsupporting

confidence: 91%

Endocrine profile following stimulation with recombinant follicle stimulating hormone and luteinizing hormone versus highly purified human menopausal gonadotropin

Ruiz

et al. 2014

Reprod Biol Endocrinol

“…Increased P levels during the early follicular phase in women undergoing controlled ovarian stimulation have been associated with a decreased probability of ongoing pregnancy (9,11,12); however, other studies have found no association between these two parameters (13,14). In the context of IUI cycles, the results of the present retrospective study show that ongoing pregnancy rates were significantly impaired in women with P levels >1.1 ng/mL compared with other P level categories.…”

Section: Discussioncontrasting

confidence: 62%

Ongoing pregnancy rates in intrauterine insemination are affected by late follicular-phase progesterone levels

Fertility and Sterility

Pacheco

et al. 2015

“…Progesterone plays a key role during the second phase of the menstrual cycle and is particularly important for implantation and progression of pregnancy; however, in the context of stimulated cycles, the potentially detrimental role of this hormone during the follicular phase has been the focus of interest and a matter of controversy for several years. Increased progesterone levels during the early follicular phase in women undergoing controlled ovarian stimulation have been suggested to be associated with a decreased probability of ongoing pregnancy [1-3]; however, many other studies have found no association between these two parameters [4,5]. The pathogenesis of raised peripheral concentrations of progesterone in the late follicular phase is likely to influence the secretory changes of the endometrium, leading to impaired endometrial receptivity [6].…”

Section: Introductionmentioning

confidence: 99%

High progesterone levels in women with high ovarian response do not affect clinical outcomes: a retrospective cohort study

Bosch

et al. 2014

Reprod Biol Endocrinol

BackgroundThe potentially detrimental role of progesterone during the follicular phase has been a matter of controversy for several years; however, few studies have analyzed the effects of combined raised estradiol and progesterone levels on pregnancy outcomes. The aim of the present study was to determine the influence of high progesterone levels on clinical outcomes in the context of high ovarian response.MethodsWe performed a retrospective cohort study that included 2850 women classified as high responders. The women were subdivided into six groups depending on their progesterone concentration on the day of human chorionic gonadotropin (hCG) administration: <0.5 ng/ml (1.81 ng/ml (>p90). Ovarian response was classified as high when > =20 oocytes were retrieved or when estradiol was > =3000 pg/ml. Clinical outcomes of each subgroup were analyzed. We also examined data from frozen-thawed embryo transfers. Results were analyzed with Student’s t- test to compare continuous variables and chi-squared test to compare proportions. A p-value of < =0.05 was considered statistically significant.ResultsThe progesterone concentration increased with ovarian response, and elevated progesterone did not show a significant clinical impact on implantation rate and pregnancy rates. These data provide evidence that progesterone levels higher than 1.8 ng/ml do not have detrimental effect on oocyte quality or endometrial receptivity.ConclusionsThese data allow us to conclude that high progesterone levels correlate significantly with high estradiol levels and that in high responder women; progesterone levels do not show a significant clinical impact on results.