Yovich, J. L., McColm, S. C., Yovich, J. M., & Matson, P. L. (1985). Early luteal serum progesterone concentrations are higher in pregnancy cycles. Fertility and Sterility, 44(2), 185-189. https://doi.org/10.1016/s0015-0282(16)48733-9
Yovich JL, McColm SC, Yovich JM, Matson PL. Early luteal serum progesterone concentrations are higher in pregnancy cycles. Fertil Steril. 1985;44(2):185-189. doi:10.1016/s0015-0282(16)48733-9
Yovich, John L., et al. "Early luteal serum progesterone concentrations are higher in pregnancy cycles." Fertility and Sterility, vol. 44, no. 2, 1985, pp. 185-189.
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Women who conceived after IVF had higher early progesterone
A 1985 Australian case series of 167 IVF patients at embryo transfer found that women who became pregnant had higher blood progesterone in the first days after egg collection. Progesterone injections raised levels in women who did not conceive. Nineteen women had a clinical pregnancy.
Key Findings
Of 167 women who reached embryo transfer, 19 had a clinical pregnancy, with a live fetus seen on ultrasound at seven to eight weeks.
Among untreated women, the 5 who became pregnant had significantly higher progesterone than the 55 who did not on days 1 to 3. On day 4 both groups were equally high.
Among women who did not conceive, those given progesterone injections had significantly higher levels on days 1 to 3 than those given none (P < 0.05).
Of 137 women allocated by alternate selection, 5 of 60 untreated women and 11 injected women became pregnant, a difference that was not significant.
The authors report that 88% of patients had no clinical pregnancy, whatever their progesterone levels.
Interpretation
The study is a case series from one Perth IVF program that used stimulation drugs. Women on their first or second attempt were allocated to injections by alternate selection. Only 5 untreated women conceived, so the pregnancy comparison rests on very small numbers, and the authors state that a larger series is needed to confirm the findings. Pregnant women who received injections had levels similar to pregnant women who did not. Blood samples were taken daily from egg collection through day 4.
RRM Context
IVF bypasses the question of why a cycle's own progesterone falls short. RRM evaluates ovulation and the luteal phase in a woman's own unstimulated cycle, where progesterone reflects ovulation and corpus luteum function.
Our editorial summary of this paper, not the article's abstract.
Abstract
In a consecutive series of 167 patients reaching the stage of embryo transfer after in vitro fertilization and embryo transfer, 19 clinical pregnancies ensued. The serum progesterone (P) levels were significantly greater on the first and second (P less than 0.01) and third (P less than 0.05) postaspiration days for those who conceived. Higher circulating levels of P were achieved on days 1, 2, and 3 (P less than 0.05) by the daily injection of P, 50 mg in oil, given for 5 consecutive days, beginning immediately after follicle aspiration. Both pregnancy and nonpregnancy cycles demonstrated high circulating P levels, but the study implies that relatively higher levels are required for conception, and such levels can be achieved by the use of intramuscular P.
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