Elevated serum progesterone does not impact euploidy rates in PGT-A patients

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)
• Embryology

Background:

• Elevated serum progesterone (P) on ovulation trigger day is observed in some stimulated IVF cycles.
• The impact of elevated P on embryo quality, particularly in conjunction with preimplantation genetic testing for aneuploidy (PGT-A), remains unclear.

Purpose of the Study:

• To investigate the association between elevated serum progesterone levels and embryo quality in women undergoing PGT-A.
• To compare embryo quality metrics between patients with high (≥ 1.5 ng/mL) and low (< 1.5 ng/mL) serum P levels on the day of ovulation trigger.

Main Methods:

• Retrospective analysis of 1597 patients undergoing IVF with a gonadotrophin-releasing hormone (GnRH) antagonist protocol.
• Serum P levels were measured on the day of ovulation trigger.
• Propensity score matching and Poisson regression were employed to analyze data, comparing age, body mass index, and ovarian sensitivity index between groups.

Main Results:

• Elevated serum P was not significantly associated with euploid embryo rate or other evaluated embryo quality variables.
• Patient age was the sole significant factor associated with euploidy rate, embryo biopsy rate, absolute number of euploid embryos, and top-quality embryo rate.
• A decrease in categorical variables was observed with each year of increased age in patients with high serum P.

Conclusions:

• Elevated serum progesterone on the day of ovulation trigger does not negatively affect the number of euploid or good-quality embryos for transfer in GnRH antagonist-supported ICSI cycles.
• These findings suggest that elevated P may not impair embryo competence, contrasting with its known effects on endometrial receptivity.
• Further research is warranted to fully elucidate the complex relationship between progesterone elevation and reproductive outcomes.