Observational studyPloS one2017
Top quality blastocyst formation rates in relation to progesterone levels on the day of oocyte maturation in GnRH antagonist IVF/ICSI cycles.
Observational study in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 119 citations in OpenAlex.
- Global transcriptomic changes occur in uterine fluid-derived extracellular vesicles during the endometrial window for embryo implantation.Human reproduction (Oxford, England) · 2021Pooled it
- Nomogram models to predict low fertilisation rate and total fertilisation failure in patients undergoing conventional IVF cycles.BMJ open · 2022Trial
- Association Between Post-Trigger Hormones andJournal of clinical gynecology and obstetrics · 2026Article
- Comparing the euploidy rate between the progestin-primed and gonadotrophin-releasing hormone antagonist protocols in preimplantation genetic testing for aneuploidy: a randomized controlled trial.Human reproduction open · 2026Article
- Article
- Progestin primed ovarian stimulation yields comparable outcomes to the GnRH antagonist protocol for controlled ovarian hyperstimulation.Scientific reports · 2025Article
- Ongoing pregnancy rate is associated with trigger-day progesterone level in letrozole/clomiphene intrauterine insemination cycles.Journal of assisted reproduction and genetics · 2025Article
- Endometrial receptivity profiled through transcriptomic analysis of uterine fluid extracellular vesicles using systems biology and bayesian modeling for pregnancy prediction.Scientific reports · 2025Article
- An analysis of freeze-all cycles to investigate the association between elevated progesterone on day of trigger and oocyte quality.Journal of assisted reproduction and genetics · 2025Article
- The effect of progesterone level on day of trigger on embryo ploidy in egg donor's cycles.Archives of gynecology and obstetrics · 2025Article
- Article
- Effects of trigger-day progesterone in c-IVF/ICSI cycles on blastocyst culture outcomes.Frontiers in endocrinology · 2025Article
- Too many embryos: a critical perspective on a global challenge.Journal of assisted reproduction and genetics · 2024Article
- Premature Progesterone Rise Is Associated with Higher Cumulative Live Birth Rate with Freeze-All Strategy.Journal of clinical medicine · 2024Article
- Progestin-primed ovarian stimulation with letrozole using different doses of medroxyprogesterone acetate per day: a retrospective cohort study.Frontiers in endocrinology · 2024Article
- The late-follicular-phase progesterone to retrieved oocytes ratio in normal ovarian responders treated with an antagonist protocol can be used as an index for selecting an embryo transfer strategy and predicting the success rate: a retrospective large-scale study.Frontiers in endocrinology · 2024Article
- The Ratio of Serum Progesterone (P4) to the Number of Follicles (P4/follicle) is a More Objective Parameter for Euploidy Rate as Compared to Systemic Progesterone Levels.Reproductive sciences (Thousand Oaks, Calif.) · 2023Observational
- Progesterone levels during ovarian stimulation in segmented ART cycles inversely correlate with normalized birthweight of neonates conceived through subsequent frozen-thawed embryo transfer.Journal of assisted reproduction and genetics · 2023Article
- Progestin Primed Ovarian Stimulation (PPOS) protocol yields lower euploidy rate in older patients undergoing IVF.Reproductive biology and endocrinology : RB&E · 2023Article
- Effects of controlled ovarian stimulation regimens on top-quality blastocyst development and perinatal outcomes with the freeze-all strategy: A retrospective comparative study.Clinical and experimental reproductive medicine · 2023Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cycles with progesterone elevation during controlled ovarian stimulation (COS) for IVF/ICSI are commonly managed with a "freeze-all" strategy, due to a well-recognized detrimental effect of high progesterone levels on endometrial receptivity. However, also a detrimental effect of elevated progesterone on day-3 embryo quality has recently been found with regards to top quality embryo formation rate. Because blastocyst culture and cryopreservation are largely adopted, we deemed relevant to determine whether this detrimental effect is also seen on blastocyst quality on day 5-6. This issue was investigated through a large two-center retrospective study including 986 GnRH antagonist IVF/ICSI cycles and using top quality blastocyst formation rate as the main outcome. Results showed that on multivariate analysis sperm motility (p<0.01) and progesterone levels at ovulation triggering (p = 0.01) were the only two variables that significantly predicted top quality blastocyst formation rate after adjusting for relevant factors including female age, BMI, basal AMH and total dose of FSH used for COS. More specifically, progesterone levels at induction showed an inverse relation with top quality blastocyst formation (correlation coefficient B = -1.08, 95% CI -1.9 to -0.02) and ROC curve analysis identified P level >1.49 ng/ml as the best cut-off for identification of patients at risk for the absence of top quality blastocysts (AUC 0.55, p<0.01). Our study is the first to investigate the top quality blastocyst formation rate in relation to progesterone levels in IVF/ICSI cycles, showing that increasing progesterone is associated with lower rates of top quality blastocyst. Hence, the advantages of prolonging COS to maximize the number of collected oocytes might eventually be hindered by a decrease in top quality blastocysts available for transfer, if increasing progesterone levels are observed. This observation extends the results of two recent studies focused on day-3 embryos and deserves further research.
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Registered trials
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