{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:02:06Z","timestamp":1791388926334,"version":"4.3.3"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T00:00:00Z","timestamp":1664323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The present study analyzed the effect of hCG trigger day progesterone (P) levels on the live birth rate (LBR) in the gonadotropin-releasing hormone (GnRH) antagonist protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This study was a single-center retrospective study. <jats:italic>In vitro<\/jats:italic> fertilization (IVF)\/intracytoplasmic sperm injection (ICSI) cycles performed from January 2017 to December 2020 were included in the analysis. This study included people with a normal ovarian response to fresh embryo transfer of GnRH antagonist protocols. All cycles were divided into 2 groups by P level on the day of human chorionic gonadotropin (hCG) trigger, P&amp;lt;1.0 ng\/ml and P\u22651.0 ng\/ml. The primary outcome measure was LBR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 867 cycles with P&amp;lt;1.0 ng\/ml and 362 cycles with P\u22651.0 ng\/ml were included in the analysis. The clinical pregnancy rate (CPR) was higher in the P&amp;lt;1.0 ng\/ml group than the P\u22651.0 ng\/ml group (44.9% vs. 37.6%, P=0.02). The early spontaneous abortion rate was comparable between the groups (14.4% vs. 14.7%, P=0.93). For live birth, the rate for the P&amp;lt;1.0 ng\/ml group was 35.3%, which was significantly higher than the 29.0% in the P\u22651.0 ng\/ml group (P=0.03). After binary logistic regression analysis, the P level on the hCG trigger day (adjusted odds ratio=0.74, 95% CI=0.55-0.99, P=0.04) was an independent risk factor for LBR. For the P level on the hCG trigger day, the LBR was lower in the P\u22651.0 ng\/ml group compared to the P&amp;lt;1.0 ng\/ml group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For normal ovarian response patients using the GnRH antagonist protocol, serum P\u22651.0 ng\/ml on the hCG trigger day resulted in a lower LBR than the P&amp;lt;1.0 ng\/ml group. When P\u22651.0 ng\/ml, whole embryo freezing may be considered.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.982830","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T05:11:36Z","timestamp":1664341896000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Effect of serum progesterone levels on hCG trigger day on pregnancy outcomes in GnRH antagonist cycles"],"prefix":"10.3389","volume":"13","author":[{"given":"Junwei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingze","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhancai","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichun","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"hoaa009","DOI":"10.1093\/hropen\/hoaa009","article-title":"ESHRE guideline: ovarian stimulation for IVF\/ICSI","volume":"2020","author":"Bosch","year":"2020","journal-title":"Hum Reprod Open"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2017.01.010","article-title":"Ovarian stimulation protocols for IVF: is more better than less","volume":"34","author":"Alper","year":"2017","journal-title":"Reprod Biomed Online"},{"key":"B3","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1093\/humupd\/dmaa040","article-title":"Progestins for pituitary suppression during ovarian stimulation for ART: A comprehensive and systematic review including meta-analyses","volume":"27","author":"Ata","year":"2021","journal-title":"Hum Reprod Update"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmx017","article-title":"GnRH antagonist versus long agonist protocols in IVF: A systematic review and meta-analysis accounting for patient type","volume":"23","author":"Lambalk","year":"2017","journal-title":"Hum Reprod Update"},{"key":"B5","article-title":"Effect of antagonists vs agonists on in vitro fertilization outcome","volume":"31","author":"Check","year":"2004","journal-title":"Clin Exp Obstet Gynecol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(84)92840-X","article-title":"Induction of ovulation for in-vitro fertilisation using buserelin and gonadotropins","volume":"324","author":"Porter","year":"1984","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e0140286","DOI":"10.1371\/journal.pone.0140286","article-title":"Is the GnRH antagonist protocol effective at preventing OHSS for potentially high responders undergoing IVF\/ICSI","volume":"10","author":"Xing","year":"2015","journal-title":"PloS One"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep436","article-title":"Flexible GnRH antagonist protocol versus GnRH agonist long protocol in patients with polycystic ovary syndrome treated for IVF: A prospective randomised controlled trial (RCT)","volume":"25","author":"Lainas","year":"2010","journal-title":"Hum Reprod (Oxf Engl)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"Cd001750","DOI":"10.1002\/14651858.CD001750.pub4","article-title":"Gonadotrophin-releasing hormone antagonists for assisted reproductive technology","volume":"4","author":"Al-Inany","year":"2016","journal-title":"Cochrane Database System Rev"},{"key":"B10","doi-asserted-by":"publisher","first-page":"Cd006919","DOI":"10.1002\/14651858.CD006919.pub4","article-title":"Gonadotrophin-releasing hormone agonist protocols for pituitary suppression in assisted reproduction","volume":"11","author":"Siristatidis","year":"2015","journal-title":"Cochrane Database System Rev"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa086","article-title":"The depot GnRH agonist protocol improves the live birth rate per fresh embryo transfer cycle, but not the cumulative live birth rate in normal responders: a randomized controlled trial and molecular mechanism study","volume":"35","author":"Xu","year":"2020","journal-title":"Hum Reprod"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.03.014","article-title":"Serum progesterone level effects on the outcome of in vitro fertilization in patients with different ovarian response: An analysis of more than 10,000 cycles","volume":"97","author":"Xu","year":"2012","journal-title":"Fertil Steril"},{"key":"B13","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12978-022-01371-4","article-title":"Effect of slightly elevated progesterone on hCG trigger day on clinical pregnancy rate in GnRH-ant IVF\/ICSI cycles","volume":"19","author":"Zhao","year":"2022","journal-title":"Reprod Health"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2012.02.003","article-title":"Effect of HCG-day serum progesterone and oestradiol concentrations on pregnancy outcomes in GnRH agonist cycles","volume":"24","author":"Wu","year":"2012","journal-title":"Reprod Biomed Online"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1016\/j.fertnstert.2015.02.038","article-title":"Are good patient and embryo characteristics protective against the negative effect of elevated progesterone level on the day of oocyte maturation","volume":"103","author":"Hill","year":"2015","journal-title":"Fertil Steril"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2015.09.005","article-title":"Impact of progesterone (on hCG day)\/oocyte ratio on pregnancy outcome in long agonist non donor fresh IVF\/ICSI cycles","volume":"55","author":"Singh","year":"2016","journal-title":"Taiwanese J Obstet Gynecol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1016\/j.fertnstert.2013.08.045","article-title":"Progesterone elevation does not compromise pregnancy rates in high responders: A pooled analysis of in vitro fertilization patients treated with recombinant follicle-stimulating hormone\/gonadotropin-releasing hormone antagonist in six trials","volume":"100","author":"Griesinger","year":"2013","journal-title":"Fertil Steril"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex010","article-title":"FSH stimulation promotes progesterone synthesis and output from human granulosa cells without luteinization","volume":"32","author":"Oktem","year":"2017","journal-title":"Hum Reprod"},{"key":"B19","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13048-021-00800-5","article-title":"The value of serum progesterone level on day of human chorionic gonadotrophin administration \/ metaphase II oocyte ratio in predicting IVF\/ICSI outcome in patients with normal ovarian reserve","volume":"14","author":"Mahran","year":"2021","journal-title":"J Ovarian Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2018.1504204","article-title":"Effect of progesterone\/estradiol ratio on pregnancy outcome of patients with high trigger-day progesterone levels undergoing gonadotropin-releasing hormone antagonist intracytoplasmic sperm injection cycles: A retrospective cohort study","volume":"39","author":"Golbasi","year":"2019","journal-title":"J Obstet Gynaecol J Institute Obstet Gynaecol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.705264","article-title":"Comparison of the cumulative live birth rates of progestin-primed ovarian stimulation and flexible GnRH antagonist protocols in patients with low prognosis","volume":"12","author":"Du","year":"2021","journal-title":"Front Endocrinol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"102223","DOI":"10.1016\/j.jogoh.2021.102223","article-title":"Double daily doses of cetrorelix may raise follicular phase progesterone more compared to single doses in poor ovarian response patients","volume":"50","author":"Ozturk","year":"2021","journal-title":"J Gynecol Obstet Hum Reproduct"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2020.1832067","article-title":"Effect of progesterone on hCG day-to-basal progesterone ratio on live birth rate in long agonist fresh IVF\/ICSI cycles: A 5-year, single-center study of more than 10,000 cycles","volume":"37","author":"Hu","year":"2021","journal-title":"Gynecol Endocrinol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.fertnstert.2017.06.005","article-title":"The international glossary on infertility and fertility care, 2017","volume":"108","author":"Zegers-Hochschild","year":"2017","journal-title":"Fertil Steril"},{"key":"B25","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1093\/humupd\/dmr039","article-title":"Ovarian antral folliculogenesis during the human menstrual cycle: A review","volume":"18","author":"Baerwald","year":"2012","journal-title":"Hum Reprod Update"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2015.05.010","article-title":"Endocrinology of the menopause","volume":"44","author":"Hall","year":"2015","journal-title":"Endocrinol Metab Clinics North Am"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.4103\/0974-1208.158606","article-title":"Do increased levels of progesterone and progesterone\/estradiol ratio on the day of human chorionic gonadotropin affects pregnancy outcome in long agonist protocol in fresh in vitro fertilization\/intracytoplasmic sperm injection cycles","volume":"8","author":"Singh","year":"2015","journal-title":"J Hum Reprod Sci"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)54186-7","article-title":"Lower pregnancy rate with premature luteinization during pituitary suppression with leuprolide acetate","volume":"55","author":"Schoolcraft","year":"1991","journal-title":"Fertil Steril"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.04.041","article-title":"Subtle progesterone rise on the day of human chorionic gonadotropin administration is associated with lower live birth rates in women undergoing assisted reproductive technology: a retrospective study with 2,555 fresh embryo transfers","volume":"98","author":"Ochsenk\u00fchn","year":"2012","journal-title":"Fertil Steril"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmm007","article-title":"Is progesterone elevation on the day of human chorionic gonadotrophin administration associated with the probability of pregnancy in in vitro fertilization","volume":"13","author":"Venetis","year":"2007","journal-title":"A System Rev Meta Analysis Hum Reprod Update"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deq125","article-title":"Circulating progesterone levels and ongoing pregnancy rates in controlled ovarian stimulation cycles for in vitro fertilization: Analysis of over 4000 cycles","volume":"25","author":"Bosch","year":"2010","journal-title":"Hum Reprod"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2010.11.002","article-title":"Progesterone rise on HCG day in GnRH antagonist\/rFSH stimulated cycles affects endometrial gene expression","volume":"22","author":"Vaerenbergh","year":"2011","journal-title":"Reprod Biomed Online"},{"key":"B33","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1093\/humrep\/deu362","article-title":"Estimating the net effect of progesterone elevation on the day of hCG on live birth rates after IVF: a cohort analysis of 3296 IVF cycles","volume":"30","author":"Venetis","year":"2015","journal-title":"Hum Reprod"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12256","article-title":"The impact of an increased progesterone-to-follicle number ratio on live delivery rates in women with normal ovarian reserve","volume":"139","author":"Chen","year":"2017","journal-title":"Int J Gynecol Obstet"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deu151","article-title":"Live birth rates after IVF are reduced by both low and high progesterone levels on the day of human chorionic gonadotrophin administration","volume":"29","author":"Santos-Ribeiro","year":"2014","journal-title":"Hum Reprod"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2021.1983780","article-title":"Progesterone elevation on the day of oocyte retrieval and live birth rate after in vitro fertilisation treatment","volume":"42","author":"Roque Fernandez","year":"2022","journal-title":"J Obstet Gynaecol J Institute Obstet Gynaecol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2004.01.027","article-title":"Prolongation of the follicular phase in in vitro fertilization results in a lower ongoing pregnancy rate in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists","volume":"82","author":"Kolibianakis","year":"2004","journal-title":"Dkgest World Latest Med Inf"},{"key":"B38","doi-asserted-by":"publisher","first-page":"951937","DOI":"10.1155\/2014\/951937","article-title":"Endometrial receptivity profile in patients with premature progesterone elevation on the day of hCG administration","volume":"2014","author":"Haouzi","year":"2014","journal-title":"BioMed Res Int"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0b013e3182402567","article-title":"Endometrial receptivity is affected in women with high circulating progesterone levels at the end of the follicular phase: A functional genomics analysis","volume":"66","author":"Labarta","year":"2011","journal-title":"Obstet Gynecol Survey"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-021-06304-3","article-title":"Serum progesterone level above 0.85 ng\/mL and progesterone\/estradiol ratio may be useful predictors for replacing cleavage-stage with blastocyst-stage embryo transfer in fresh IVF\/ICSI cycles without premature progesterone elevation","volume":"305","author":"Tokgoz","year":"2022","journal-title":"Arch Gynecol Obstet"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.982830\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T05:11:39Z","timestamp":1664341899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.982830\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,28]]},"references-count":40,"alternative-id":["10.3389\/fendo.2022.982830"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.982830","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,28]]},"article-number":"982830"}}