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Journal of Assisted Reproduction and Genetics
Published in: Journal of Assisted Reproduction and Genetics 4/2010

01-04-2010 | EXPERIMENTAL ASSISTED REPRODUCTION

Progesterone rise on the day of HCG administration (premature luteinization) in IVF: An overdue update

Author: Aboubakr M. Elnashar

Published in: Journal of Assisted Reproduction and Genetics | Issue 4/2010

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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.
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Metadata
Title
Progesterone rise on the day of HCG administration (premature luteinization) in IVF: An overdue update
Author
Aboubakr M. Elnashar
Publication date
01-04-2010
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 4/2010
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-010-9393-8

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