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 NF-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 E(2) and P. Main Outcome Measures: Measurement of LH, P, and E(2); 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 less than or equal to 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.