The relationship between serum progesterone level on the day of HCG trigger in IVF/ICSI cycles and oocyte maturation and embryo quality: a retrospective observational study.

Purpose: Previous studies have suggested a link between serum progesterone levels on the day of the HCG trigger in IVF cycles and oocyte and embryo quality. This study aims to explore this relationship more thoroughly.

Methods: This study included 496 infertility patients at Moloud Infertility Treatment Center, Zahedan, Iran. Statistical methods were used to assess factors such as oocyte maturation and embryo quality, fertilization rate, BMI, and gonadotropin dosage.

Results: While an initial progesterone cutoff of 1.2 ng/ml was used to perform fundamental analysis, a more accurate cutoff of 1.54 ng/ml was identified, beyond which the average number of M1 oocytes significantly declined. A strong relationship was found between higher progesterone levels and a greater number of retrieved oocytes (p = 0.004), with M1 oocytes showing a similar relation. Also, BMI was significantly related to the quality of eight-cell grade B embryos (p = 0.006). However, no significant correlations were found between progesterone levels and other factors, including patient age (p = 0.327), fertilization rate (p = 0.603), or embryo quality at other stages.

Conclusions: The findings demonstrate that elevated progesterone level, particularly beyond the identified cutoff of 1.54 ng/ml, is a valuable clinical indicator of suboptimal IVF outcomes due to its negative impact on oocyte maturation.