Progesterone peak influences embryonic developmental morphokinetics on trigger day? A retrospective study.

Area of Science:

• Reproductive Endocrinology
• Assisted Reproductive Technologies
• Embryology

Background:

• Premature Progesterone Rise (PPR) is defined as elevated serum progesterone levels near hCG trigger.
• The impact of PPR on IntraCytoplasmic Sperm Injection (ICSI) outcomes remains a subject of investigation.

Purpose of the Study:

• To evaluate the effect of progesterone levels ≥ 1.5 ng/ml on the hCG trigger day on embryo morphokinetics.
• To identify potential predictive biomarkers for ICSI cycle success in the context of PPR.

Main Methods:

• Retrospective study of 116 ICSI cycles (2020-2023), comparing 58 patients with progesterone ≥ 1.5 ng/ml (study group) to 58 controls with progesterone < 1.5 ng/ml.
• Collected baseline patient characteristics (age, BMI, AFC, AMH, FSH) and ICSI cycle data (eggs retrieved, fertilized, blastocysts).
• Utilized Time-Lapse technology to assess embryo morphokinetics and blastocyst quality.

Main Results:

• Elevated progesterone levels (≥ 1.5 ng/ml) were associated with a higher antral follicle count, leading to more retrieved eggs, mature eggs, fertilized eggs, and blastocysts.
• Morphokinetic analysis revealed faster initial embryo division times in the study group.
• A significantly greater number of high-grade blastocysts were observed in patients with elevated progesterone.

Conclusions:

• Progesterone levels ≥ 1.5 ng/ml on the hCG trigger day do not negatively affect embryonic morphokinetic parameters in ICSI cycles.
• Elevated progesterone may be linked to faster early-stage embryo development.
• Higher progesterone levels might correlate with improved blastocyst quality and quantity.