Vol.:(0123456789) 1 3 Archives of Gynecology and Obstetrics https://doi.org/10.1007/s00404-020-05792-z GYNECOLOGIC ENDOCRINOLOGY AND REPRODUCTIVE MEDICINE Being on the side of old ﬁndings: progesterone elevation on the day of oocyte maturation induction does not aﬀect embryological parameters throughout the blastocyst culture period Emre Niyazi Turgut 1 · Selen Ecemis 1 · Kubra Fazilet Boynukalin 1 · Meral Gultomruk 1 · Zalihe Yarkiner 2 · Necati Findikli 1 · Mustafa Bahceci 1 Received: 16 March 2020 / Accepted: 5 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Purpose To investigate whether there is any detrimental eﬀect of progesterone elevation (PE) on the day of oocyte matura- tion induction on embryological development potentials. Methods This retrospective single-center cohort study included a total of 1485 individual intracytoplasmic sperm injection (ICSI) cycles between January 2014 and December 2018. Serum progesterone (P) levels were measured on the day of oocyte maturation induction following the GnRH antagonist suppression protocol. Embryological parameters such as maturation, fertilization rate (FR), top-quality embryo (TQE) formation rate per 2PN on day 3, and excellent-quality blastocyst (EQB) formation rate per 2PN on day 5/6 were recorded. The inclusion criteria for women were an age ≤ 37 years, a BMI ≤ 30 kg/ m 2 , and access to a total sperm concentration ≥ 2 million. Groups were stratiﬁed according to the serum P levels using the cut-oﬀ levels of < 0.8 ng/ml; 0.8–1.49 ng/ml; and ≥ 1.5 ng/ml. Results Peak E2 level and total number of oocytes retrieved were signiﬁcantly related to PE (p < 0.001). FR did not display a signiﬁcance diﬀerence between groups (p = 0.108). The TQE and the blastulation rates were not aﬀected by PE (p = 0.82 and p = 0.68, respectively). Chi square analysis revealed a signiﬁcant relationship between PE and the EQB formation rate (p = 0.01). GEE analysis failed to present any statistical signiﬁcance regarding the eﬀect of PE on neither the TQE nor the EQB formation rates per 2PN [OR 1.07; 95% (0.98–1.16) p = 0.113 and OR 0.93; 95% (0.80–1.07) p = 0.32, respectively]. Conclusions In accordance with previously published papers, our study could not ﬁnd any detrimental eﬀect of PE on embryological outcomes throughout the blastocyst culture period. Keywords Progesterone elevation · Blastocyst culture · Blastulation · Excellent-quality blastocyst formation rate Purpose The eﬀect of late follicular phase progesterone elevation (PE) in controlled ovarian hyperstimulation (COH) cycles has been a major controversy that is of ongoing importance. Although many studies and meta-analysis have been car- ried out so far, and increased serum progesterone (P) levels have been shown to have a negative impact on pregnancy outcomes, discussions about the precise P cut-oﬀ value and the use of diﬀerent assays are still ongoing. Most authors conducted the discussion through embryo-endometrium asynchrony. Recent publications have veriﬁed the signiﬁcant negative impacts of PE on pregnancy outcomes, especially when fresh embryo transfer is performed [1–3]. Moreover, gene expression studies have related this negative eﬀect to premature development of the endometrium [4, 5]. Today, the most commonly used threshold for serum progesterone (P) level is 1.5 ng/ml, and it ranges between 0.8 and 2 ng/ml among published studies [6]. The afore- mentioned gene expression studies have found signiﬁcant diﬀerences in gene expression proﬁles between two groups with P levels above and below 1.5 ng/ml on the day of trig- gering ovulation [4]. * Emre Niyazi Turgut dremreturgut@gmail.com 1 Bahceci Health Group, Hakki Yeten Cad. No:11 Terrace Fulya, Fulya, Sisli/Istanbul, Turkey 2 Department of Statistics, CYPRUS Science University, 99320 Dr. Fazil Kucuk Cad, Ozankoy, Kyrenia, Cyprus