Progesterone Rise on the Day of HCG Administration (premature Luteinization) in IVF: an Overdue Update

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2010 Feb 24

PMID 20177771

Citations 29

Authors

Aboubakr M Elnashar

Affiliations

Soon will be listed here.

Abstract

Premature luteinization (PL) refers to a rise in serum progesterone (P) levels on the day of hCG administration. Most studies used an absolute P level on the day of hCG administration as an indicator of PL, and the cutoff level differed from 0.8 to 2 ng/mL. Some authors defined PL as a P/E2 ratio of >1. There is a marked variation in the incidence (13% to 71%), of PL due to discrepancies in definition, population characteristics and/or treatment protocols. The pathogenesis of PL in COH is still poorly understood. Several hypotheses may be considered to explain this phenomenon: elevation of follicular LH levels, serum accumulation of HCG from HMG, increased LH receptor sensitivity of the granulosa cells to FSH, or poor ovarian response with increased LH sensitivity. The consequences of this premature elevation of serum P on IVF outcome remain controversial. Attempts to prevent COH include: use of Low-dose hCG alone in the late COH stages, flexible antagonist protocol, use of mifepristone, aspiration of a single leading follicle, hCG administration when the levels of serum P exceeded 1.0 ng/mL.

Citing Articles

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Independent value of PMOI on hCG day in predicting pregnancy outcomes in IVF/ICSI cycles.

Sun X, Yao F, Yin C, Meng M, Lan Y, Yang M Front Endocrinol (Lausanne). 2023; 14:1086998.

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