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Delayed blastocyst development is influenced by the level of progesterone on the day of trigger

  • Assisted Reproduction Technologies
  • Published:
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Abstract

Purpose

To evaluate the association between progesterone (P) level on the day of trigger and time to blastulation in IVF cycles.

Methods

This was a retrospective cohort study with autologous IVF cycles performed at our Institution from January 2019 to December 2021. A total of 1109 IVF cycles were included. The primary outcome was to compare time to blastulation in terms of percentage of expanded (grade 3) blastocysts on day 5 according to progesterone level at trigger.

Results

A total of 3517 blastocysts were analyzed. After dividing progesterone level in quartiles (Q1, P < 0.50 ng/ml; Q2 0.50 ng/ml ≤ P ≤ 0.78 ng/ml; Q3, 0.79 ng/ml ≤ P ≤ 1.15 ng/ml; Q4, P > 1.15 ng/ml), we observed a delay in blastocyst development according to the increasing level of progesterone at trigger (analysis by rank, P-value = 0.01). After adjusting for confounding factors at the multivariate analysis, the percentage of day 5 blastocysts was reduced for Q3 (− 13.8%, 95% CI from − 20.5 to − 7.0%, p < 0.001) and Q4 (− 7.7%, 95% CI from − 15.5 to 0.0%, p = 0.05) compared to Q1 (reference).

Conclusions

Progesterone levels on day of trigger correlate to the percentage of expanded (grade 3) blastocysts on day 5 and a delayed blastocyst development day 5 is expected for high progesterone levels.

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Authors and Affiliations

  1. Gynecology/Obstetrics Unit, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy

    Roberta Villanacci, Giovanni Buzzaccarini, Valeria Stella Vanni, Lucia De Santis, Alessandra Alteri, Massimo Candiani & Enrico Papaleo

  2. Reproductive Sciences Lab, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Daria Marzanati & Luca Pagliardini

  3. Department of Brain and Behavioral Sciences, University of Pavia, 27100, Pavia, Italy

    Luca Pagliardini

Authors
  1. Roberta Villanacci
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  2. Giovanni Buzzaccarini
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  3. Daria Marzanati
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  4. Valeria Stella Vanni
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  5. Lucia De Santis
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  6. Alessandra Alteri
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  7. Massimo Candiani
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  8. Luca Pagliardini
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  9. Enrico Papaleo
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Corresponding author

Correspondence to Luca Pagliardini.

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Conflict of interest

E.P. reports grant and personal fees from MSD, grants from Ferring, from IBSA, grants and personal fees from Merck, grants from TEVA, grants from Gedeon Richter, not related to the present study. All the other authors have no conflicts of interest to declare.

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Villanacci, R., Buzzaccarini, G., Marzanati, D. et al. Delayed blastocyst development is influenced by the level of progesterone on the day of trigger. J Assist Reprod Genet 40, 361–370 (2023). https://doi.org/10.1007/s10815-022-02682-y

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  • DOI: https://doi.org/10.1007/s10815-022-02682-y

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