Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles
Progesterone elevation (PE) during the late follicular phase of controlled ovarian stimulation in fresh embryo transfer in vitro fertilization (IVF)/intracytoplasmic sperm injection cycles has been claimed to be associated with decreased pregnancy rates. However, the evidence is not unequivocal, and...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
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Frontiers Media S.A.
2018-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fendo.2018.00201/full |
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| author | Sandro C. Esteves Sandro C. Esteves Sandro C. Esteves Gautam Khastgir Jatin Shah Kshitiz Murdia Shweta Mittal Gupta Durga G. Rao Soumyaroop Dash Kundan Ingale Milind Patil Kunji Moideen Priti Thakor Pavitra Dewda |
| author_facet | Sandro C. Esteves Sandro C. Esteves Sandro C. Esteves Gautam Khastgir Jatin Shah Kshitiz Murdia Shweta Mittal Gupta Durga G. Rao Soumyaroop Dash Kundan Ingale Milind Patil Kunji Moideen Priti Thakor Pavitra Dewda |
| author_sort | Sandro C. Esteves |
| collection | DOAJ |
| description | Progesterone elevation (PE) during the late follicular phase of controlled ovarian stimulation in fresh embryo transfer in vitro fertilization (IVF)/intracytoplasmic sperm injection cycles has been claimed to be associated with decreased pregnancy rates. However, the evidence is not unequivocal, and clinicians still have questions about the clinical validity of measuring P levels during the follicular phase of stimulated cycles. We reviewed the existing literature aimed at answering four relevant clinical questions, namely (i) Is gonadotropin type associated with PE during the follicular phase of stimulated cycles? (ii) Is PE on the day of human chorionic gonadotropin (hCG) associated with negative fresh embryo transfer IVF/intracytoplasmic sperm injection (ICSI) cycles outcomes in all patient subgroups? (iii) Which P thresholds are best to identify patients at risk of implantation failure due to PE in a fresh embryo transfer? and (iv) Should a freeze all policy be adopted in all the cycles with PE on the day of hCG? The existing evidence indicates that late follicular phase progesterone rise in gonadotropin releasing analog cycles is mainly caused by the supraphysiological stimulation of granulosa cells with exogenous follicle-stimulating hormone. Yet, the type of gonadotropin used for stimulation seems to play no significant role on progesterone levels at the end of stimulation. Furthermore, PE is not a universal phenomenon with evidence indicating that its detrimental consequences on pregnancy outcomes do not affect all patient populations equally. Patients with high ovarian response to control ovarian stimulation are more prone to exhibit PE at the late follicular phase. However, in studies showing an overall detrimental effect of PE on pregnancy rates, the adverse effect of PE on endometrial receptivity seems to be offset, at least in part, by the availability of good quality embryo for transfer in women with a high ovarian response. Given the limitations of the currently available assays to measure progesterone at low ranges, caution should be applied to adopt specific cutoff values above which the effect of progesterone rise could be considered detrimental and to recommend “freeze-all” based solely on pre-defined cutoff points. |
| first_indexed | 2024-12-24T03:39:52Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-24T03:39:52Z |
| publishDate | 2018-04-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-55fb045bc2184e7a8794b7a75512089e2022-12-21T17:16:56ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922018-04-01910.3389/fendo.2018.00201352437Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection CyclesSandro C. Esteves0Sandro C. Esteves1Sandro C. Esteves2Gautam Khastgir3Jatin Shah4Kshitiz Murdia5Shweta Mittal Gupta6Durga G. Rao7Soumyaroop Dash8Kundan Ingale9Milind Patil10Kunji Moideen11Priti Thakor12Pavitra Dewda13ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, BrazilDivision of Urology, Department of Surgery, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, BrazilFaculty of Health, Aarhus University, Aarhus, DenmarkBIRTH, Kolkata, IndiaMumbai Fertility Center – Kamala Polyclinic & Nursing Home, Mumbai, IndiaIndira IVF Group, Udaipur, IndiaSir Ganga Ram Kolmet Hospital, New Delhi, IndiaOasis Centre for Reproductive Medicine, Hyderabad, IndiaSrishti Assisted Fertility & Advanced Laparoscopy Center, Srishti Hospital, Moolakulam, India0Nirmiti Clinic, Centre for Assisted Reproduction, Chinchwad, India1Shobha Nursing Home, Solapur, India2ARMC IVF Fertility Centre, Kozhikode, India3Merck Limited, Mumbai, India3Merck Limited, Mumbai, IndiaProgesterone elevation (PE) during the late follicular phase of controlled ovarian stimulation in fresh embryo transfer in vitro fertilization (IVF)/intracytoplasmic sperm injection cycles has been claimed to be associated with decreased pregnancy rates. However, the evidence is not unequivocal, and clinicians still have questions about the clinical validity of measuring P levels during the follicular phase of stimulated cycles. We reviewed the existing literature aimed at answering four relevant clinical questions, namely (i) Is gonadotropin type associated with PE during the follicular phase of stimulated cycles? (ii) Is PE on the day of human chorionic gonadotropin (hCG) associated with negative fresh embryo transfer IVF/intracytoplasmic sperm injection (ICSI) cycles outcomes in all patient subgroups? (iii) Which P thresholds are best to identify patients at risk of implantation failure due to PE in a fresh embryo transfer? and (iv) Should a freeze all policy be adopted in all the cycles with PE on the day of hCG? The existing evidence indicates that late follicular phase progesterone rise in gonadotropin releasing analog cycles is mainly caused by the supraphysiological stimulation of granulosa cells with exogenous follicle-stimulating hormone. Yet, the type of gonadotropin used for stimulation seems to play no significant role on progesterone levels at the end of stimulation. Furthermore, PE is not a universal phenomenon with evidence indicating that its detrimental consequences on pregnancy outcomes do not affect all patient populations equally. Patients with high ovarian response to control ovarian stimulation are more prone to exhibit PE at the late follicular phase. However, in studies showing an overall detrimental effect of PE on pregnancy rates, the adverse effect of PE on endometrial receptivity seems to be offset, at least in part, by the availability of good quality embryo for transfer in women with a high ovarian response. Given the limitations of the currently available assays to measure progesterone at low ranges, caution should be applied to adopt specific cutoff values above which the effect of progesterone rise could be considered detrimental and to recommend “freeze-all” based solely on pre-defined cutoff points.http://journal.frontiersin.org/article/10.3389/fendo.2018.00201/fullassisted reproductive technologycontrolled ovarian stimulationhuman chorionic gonadotropin triggerintracytoplasmic sperm injectionin vitro fertilizationlate follicular phase |
| spellingShingle | Sandro C. Esteves Sandro C. Esteves Sandro C. Esteves Gautam Khastgir Jatin Shah Kshitiz Murdia Shweta Mittal Gupta Durga G. Rao Soumyaroop Dash Kundan Ingale Milind Patil Kunji Moideen Priti Thakor Pavitra Dewda Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles Frontiers in Endocrinology assisted reproductive technology controlled ovarian stimulation human chorionic gonadotropin trigger intracytoplasmic sperm injection in vitro fertilization late follicular phase |
| title | Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles |
| title_full | Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles |
| title_fullStr | Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles |
| title_full_unstemmed | Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles |
| title_short | Association Between Progesterone Elevation on the Day of Human Chronic Gonadotropin Trigger and Pregnancy Outcomes After Fresh Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles |
| title_sort | association between progesterone elevation on the day of human chronic gonadotropin trigger and pregnancy outcomes after fresh embryo transfer in in vitro fertilization intracytoplasmic sperm injection cycles |
| topic | assisted reproductive technology controlled ovarian stimulation human chorionic gonadotropin trigger intracytoplasmic sperm injection in vitro fertilization late follicular phase |
| url | http://journal.frontiersin.org/article/10.3389/fendo.2018.00201/full |
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