The significance of elevated progesterone at the time of administration of human chorionic gonadotropin may be related to luteal support

Abstract

These data suggest that oocytes and embryos derived from patients with high preovulatory progesterone are not of a reduced quality. The association of high progesterone concentrations with a reduced rate of pregnancy varied with the type of luteal support.

Premature progesterone rise negatively correlated with live birth rate in IVF cycles with GnRH agonist: an analysis of 2,566 cycles

“…Some studies used logistic regression to analyze which factors were involved in PPR (14), but P level must be categorized into two groups in that method, which may magnify or minify the influence of some factors, because P level is a continuous variable. Based on these pioneer studies, four possible explanations of the occurrence of PPR were documented, i.e., multiple follicle growth (8,9), overdose of exogenous gonadotropin (14), premature lutineization (18), and poor ovarian response (19). The former three partly explain the reasons for PPR from limited facets, and the last one is not that convincing, because we found that women with lower basal FSH level were inclined to have PPR.…”

“…Some showed that PPR was associated with decreased pregnancy rate (6)(7)(8), some presented data against the negative effect of PPR (9)(10)(11), and some even reported positive correlation between PPR and pregnancy rate (12). In 2007, Venetis et al (13) published the first systematic review and meta-analysis, including 12 studies, and concluded that PPR was not associated with the probability of pregnancy.…”

“…Some showed that the premature of endometrium, a detrimental factor to the endometrial receptivity, was the reason for low pregnancy rate related to PPR (15), whereas some documented that the compromised quality of oocytes might also be a cause (16,17). As for the pathogenesis and etiology of PPR, which are also poorly understood, several possible mechanisms were suggested, including: 1) the accumulated P production from multiple follicles being developed during controlled ovarian stimulation (COS), each one producing a normal amount of P (8,9); 2) the overdose of exogenous gonadotropin promoting the conversion of P from cholesterol by acting on granulosa cells (14); 3) premature luteinization, the consequence of subtle LH rise which occurs even when GnRH analogue used (18); and 4) poor ovarian response with increased LH sensitivity (19).…”

The Impact of Serum Progesterone Levels on the Results ofIn VitroFertilization Treatments: A Literature Review

“…There have already been many papers published on this topic; however, some of them do not show a relationship between progesterone levels and pregnancy rates (Check, 1994;Bustillo et al, 1995;Levy et al, 1995;Miller et al, 1996;Venetis et al, 2007;Edelstein et al, 1990;Ubaldi et al, 1995;Silverberg et al, 1991). The latter work is a meta-analysis, which has some points of controversy like the lack of uniformity regarding the type of GnRH analogue used as well as the cutoff to define elevated serum progesterone.…”

Self‐control study on reduced‐dose depot versus daily administration of gonadotrophin‐releasing hormone agonists for pituitary desensitization in in vitro fertilization cycles

“…The pathogenesis and causes of premature increase in progesterone levels are poorly understood. Several possible mechanisms are suggested, including (i) accumulated progesterone production resulting from the development of multiple follicles during controlled ovarian stimulation, with each one producing a normal amount of progesterone; (ii) overdose of exogenous gonadotrophin promoting the conversion of progesterone from cholesterol via the action of gonadotrophin on granulosa cells; (iii) premature luteinization, the consequence of a subtle increase in LH, which occurs even when GnRH analogues are used; and (iv) poor ovarian response with increased LH sensitivity . Some researchers found that exogenous gonadotrophin dose, the duration of stimulation, E 2 and LH levels on the day of hCG administration, the number of oocytes retrieved, and basal FSH level are all related with premature progesterone rise .…”