Association of Blood Progesterone Levels on Trigger Day and Low Oocyte Retrieval in Cases With Polycystic Ovary Syndrome Undergoing In-Vitro Fertilization: A Prospective Cohort Study Publisher



N Bahrami NAHID ; A Moini ASHRAF ; L Kashani LADAN ; M Khodarahmian MAHSHAD
Source: International Journal of Reproductive BioMedicine Published:2025

Abstract

Background: The number of follicles aspirated during intracytoplasmic sperm injection (ICSI)/in vitro fertilization (IVF) treatment does not always match the number of oocytes recovered. Objective: This study aimed to assess the oocyte retrieval rate (ORR) distribution data and investigate the risk factors for low ORR in polycystic ovary syndrome (PCOS) cases undergoing IVF/ICSI. Materials and Methods: This prospective cohort study was conducted on 140 women aged between 18 and 40 yr with PCOS who were referred to Arash hospital in Tehran, Iran for ICSI/IVF treatment from March to November 2024. The ratio of obtained oocytes to follicles (≥ 17 mm) on the trigger day was used to determine the OPR. 140 women were split into 2 groups: one with a low ORR and one with a normal ORR, each separated by one standard deviation from the ORR mean. Results: No significant difference was observed between the low and normal ORR groups for progesterone levels. A statistically significant difference was observed in terms of estradiol/follicle ratio above 17, number of follicles above 17, and number of retrieved eggs between the low and normal ORR groups. Logistic regression analysis showed that serum estradiol/follicle ratio (≥ 17 mm) with (OR = 0.96, 95% CI [0.94–0.98], p = 0.001) was a factor affecting low ORR. Conclusion: Low ORR, which results in fewer embryos and more cycle cancellations, may be caused by low progesterone levels on the trigger day, low estradiol levels/follicles (≥ 17 mm), and the use of the progestin-primed regimen in PCOS cases. © 2025 Elsevier B.V., All rights reserved.