Premature progesterone elevation does not alter oocyte quality in in vitro fertilization.

OBJECTIVE

To clarify whether premature P elevation during controlled ovarian hyperstimulation (COH) for IVF-ET affects adversely oocyte-embryo quality.

DESIGN

Controlled clinical study.

PATIENTS: We studied 102 fertile donors undergoing 106 oocyte retrievals and 117 recipients undergoing 162 ET.

INTERVENTIONS: Donors underwent COH with a time-release GnRH agonist and hMG. All recipients had inactive or absent ovaries and were primed with E2 and P.

MAIN OUTCOME MEASURES: Measurement of LH, P and E2; characteristics of COH; cleavage, pregnancy, and implantation rates.

RESULTS

According to donors' plasma P levels on the day of hCG, two groups were defined: P < or = 0.9 ng/mL (conversion factor to SI unit, 3.18), group A, and P > 0.9 ng/mL, group B. Similar results of cleavage (65% and 72%), clinical (30% and 29%), and ongoing pregnancy (20% and 18%), and implantation (14% and 15%) rates were observed in both groups, respectively.

CONCLUSIONS

The lack of difference in cleavage, pregnancy, and implantation rates between both groups suggests that preovulation increase in P production does not alter oocyte-embryo quality. Hence, the reported adverse effects on IVF outcome of pre-hCG elevation of P is likely to reflect an impaired endometrial receptivity in the high P group.