The impact of late follicular progesterone level on in vitro fertilization-intracytoplasmic sperm injection outcome: Case-control study.

Novia D; Putri Lubis H; Halim B; Pustimbara A; Lestari R; A. Abinawanto; Anom Bowolaksono

doi:10.18502/ijrm.v13i5.7157

The impact of late follicular progesterone level on in vitro fertilization-intracytoplasmic sperm injection outcome: Case-control study.

Novia D, Putri Lubis H, Halim B, Pustimbara A, Lestari R, A. Abinawanto, Anom Bowolaksono

International journal of reproductive biomedicine · 2020 · doi:10.18502/ijrm.v13i5.7157 · PMID:32637865 · PMC7306063

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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-14 ⓘ

This case-control study found that higher progesterone levels on the day of hCG injection in IVF-ICSI cycles correlated with a greater number of oocytes retrieved.

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This case-control study evaluated whether late follicular serum progesterone level measured in the morning of hCG trigger is associated with IVF outcomes in 245 infertile women undergoing IVF-ICSI at a single Indonesian fertility center (Jan–Aug 2018). Progesterone was grouped as low (≤0.50 ng/mL), normal (0.51–1.50 ng/mL), or high (>1.50 ng/mL), and outcomes included number of oocytes retrieved, maturation rate, fertilization rate, and day-3 embryo quality categories (good, fair, poor), with embryo morphology assessed using the Istanbul/ALPHA consensus. High progesterone was linked to a significantly higher number of oocytes retrieved, while maturation and fertilization rates were highest in the low-progesterone group and differed significantly across groups; embryo quality patterns also differed, with group 2 showing the highest proportion of fair embryos. A key limitation explicitly indicated by the study’s framing is that this was an observational comparison with no direct demonstration of endometrial or mechanistic effects beyond the hormone–outcome associations, despite prior debate about premature luteinization; the paper does not explicitly discuss endometriosis or adenomyosis beyond mentioning endometriosis as a general cause of infertility in the background.

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Abstract

BackgroundStudies have been conducted to improve the pregnancy rate through the in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) program. In recent years, researchers have been focusing on finding impact of high progesterone level on endometrial receptivity. However, data on whether progesterone level also affects the quality of the embryo is still limited.ObjectiveThe aim is to assess the effect of late follicular progesterone level on the outcome of in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI).Materials and methodsThis was a case-control of 245 women who underwent in vitro fertilization cycle at Halim Fertility Center, Indonesia. The outcomes assessed were number of oocytes retrieved (OR), maturation rate (MR), fertilization rate (FR), number of good embryos (GE), number of fair embryos (FE), and number of poor embryos (PE). The progesterone (P4) and estradiol (E2) levels were analyzed on the day of human chorionic gonadotropin injection. Serum progesterone level was divided into three groups: 1. low progesterone ( ≤ 0.50 ng/ml), 2. normal progesterone (0.51-1.50 ng/ml), and 3. high progesterone ( > 1.50 ng/ml). All outcomes were compared amongst the groups.ResultsSignificant differences occurred between progesterone level on the day of human chorionic gonadotropin administration. The number of OR in group 1, 2, and 3 were 8.41 ± 5.88 vs. 12.99 ± 8.51 vs. 17.58 ± 9.52, respectively.ConclusionProgesterone level on the day of human chorionic gonadotropin injection may have an impact on the outcome of IVF-ICSI.

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Section

Increased progesterone level on the day of follicle maturation may not affect embryo quality but may have an adverse effect on oocyte maturation and FRs. Elevated estradiol and progesterone level on the day of hCG injection were the effects of the increasing number and size of follicles.

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There is no conflict of interest that could affect the impartiality of the study conducted.

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