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

• Published in: Reproductive sciences (Thousand Oaks, Calif.) Calif.), 2023-10, Vol.30 (10), p.3046-3054
• Main Authors: Ali, Khaled Ibrahim Abu, Lawrenz, Barbara, Shanker, Upma, Ruiz, Francisco, El-Damen, Ahmed, ElKhatib, Ibrahim, Fatemi, Human, De Munck, Neelke
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aneuploidy; Blastocyst - pathology; Embryology; Female; Fertilization in Vitro - methods; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Obstetrics/Perinatology/Midwifery; Ovarian Follicle; Ploidies; Pregnancy; Pregnancy Rate; Preimplantation Diagnosis - methods; Progesterone; Reproductive Endocrinology: Original Article; Reproductive Medicine; Retrospective Studies; Semen; Young Adult
• ISSN: 1933-7191; 1933-7205; 1933-7205
• DOI: 10.1007/s43032-023-01258-0

Does the late follicular phase progesterone (P4) and the P4-to-follicle-ratio affect the ploidy state of the biopsied embryos? A retrospective observational study conducted at ART Fertility Clinics Abu Dhabi and Muscat, including all stimulation cycles performed between January 2015 and December 2019. In total, 975 cycles were considered for this study. Inclusion criteria were ovarian stimulation due to primary/secondary infertility, patient’s age between 18 and 45 years, ICSI as fertilization method, and patients undergoing preimplantation genetic testing for aneuploidies (PGT-A). Patients with testicular sperm extraction (TESE) and warmed oocytes were excluded. Our results have shown that progesterone had no effect on the euploid rate ( p = 0.371). However, when adding the ratio of P4 to the number of follicles that were bigger than 10 mm in the last scan, a negative effect on the euploid rate ( p < 0.05) was observed. This study was able to show that the use of only P4 is unable to predict ploidy outcomes. However, by including the number of follicles > 10 mm, a clear association was observed between P4/Foll ratio and euploid rate per cycle. The use of both parameters could aid clinicians in their decision to trigger a patient or continue stimulation. Further prospective studies are warranted to confirm those results.