Effect of Gonadotropin Dose Reduction during Controlled Ovarian Hyperstimulation on Progesterone Levels and Embryo...

This study investigates the impact of reduced gonadotropin doses during controlled ovarian hyperstimulation (COH) on progesterone levels in the late follicular phase of IVF/ICSI-ET.

This was a retrospective cohort study employing propensity score matching to balance groups. Participants/Materials: This study enrolled infertile patients undergoing IVF/ICSI-ET at the Reproductive Medicine Center of the 900th Hospital from January 2017 to July 2020.

This study was carried out at the Reproductive Medicine Center, 900th Hospital of PLA Joint Logistic Support Force, formerly Fuzhou General Hospital.

A total of 1,380 patients were enrolled; 670 received reduced gonadotropin doses (12.5-75 units/day from days 6 to 8), and 710 underwent routine treatment. The primary outcome measured was progesterone levels on trigger day.

Progesterone levels on trigger day were significantly lower in the gonadotropin dose reduction group (1.24 ± 0.51) compared to the control group (1.34 ± 0.53, p < 0.001). The proportion of patients with P ≥1.5 ng/mL was significantly lower in the gonadotropin dose reduction group compared to the control group (22.7% vs. 29.9%, p = 0.003). Multivariable logistic regression indicated that dose reduction decreased the risk of progesterone elevation (OR = 0.535, 95% CI: 0.404-0.709).

The study is limited by its retrospective design, which may introduce biases.

Reducing gonadotropin doses during COH may lower elevated progesterone levels in the late follicular phase, potentially improving embryo outcomes in IVF/ICSI-ET.