Ivanovic Katarina, Tulic Lidija, Tulic Ivan, Ivanovic Stefan, Stojnic Jelena, Bila Jovan, Dosev Tatjana, Vukovic Zeljka, Milosevic Branislav
Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
J Clin Med. 2025 Aug 23;14(17):5965. doi: 10.3390/jcm14175965.
The success of artificial reproductive technologies (ARTs) depends on different factors, such as patient-specific reproductive features, ovarian response to stimulation, oocyte and embryo quality, and endometrial receptivity. This study aimed to evaluate their association with oocyte yield, fertilization, endometrial thickness, and pregnancy outcomes. A prospective clinical study included 128 women undergoing IVF/ICSI. Baseline hormone levels (E2, P4, FSH, LH, AMH) were assessed prior to stimulation. E2 levels were monitored during stimulation, and P4 was measured on the day of oocyte retrieval. Patients were grouped based on P4 levels (<2 ng/mL vs. ≥2 ng/mL). IVF outcomes and endometrial characteristics were statistically analyzed. Lower P4 levels (<2 ng/mL) on the day of oocyte retrieval were significantly associated with higher fertilization rates ( < 0.003), more fertilized oocytes ( < 0.001), and increased pregnancy rates ( < 0.001). Elevated P4 (≥2 ng/mL) correlated with a higher frequency of thin endometrium (<7 mm, < 0.007). E2 levels on the hCG trigger day correlated positively with the number of retrieved and mature oocytes and fertilization outcomes ( < 0.05). Patients who achieved pregnancy had lower P4 and BMI, and higher E2, AMH, and endometrial thickness. ROC identified a P4 threshold of 1.99 ng/mL with moderate predictive value. Elevated progesterone levels on the day of oocyte retrieval negatively impact fertilization and pregnancy outcomes, likely due to impaired endometrial receptivity. Combined assessment of P4, E2, AMH, and endometrial thickness may enhance embryo transfer planning and improve IVF success rates.
辅助生殖技术（ARTs）的成功取决于不同因素，如患者特定的生殖特征、卵巢对刺激的反应、卵母细胞和胚胎质量以及子宫内膜容受性。本研究旨在评估它们与卵母细胞产量、受精、子宫内膜厚度和妊娠结局的关联。一项前瞻性临床研究纳入了128例行体外受精/卵胞浆内单精子注射（IVF/ICSI）的女性。在刺激前评估基线激素水平（雌二醇、孕酮、促卵泡生成素、促黄体生成素、抗苗勒管激素）。在刺激期间监测雌二醇水平，并在取卵日测量孕酮。根据孕酮水平（<2 ng/mL与≥2 ng/mL）对患者进行分组。对IVF结局和子宫内膜特征进行统计学分析。取卵日较低的孕酮水平（<2 ng/mL）与较高的受精率（<0.003）、更多的受精卵母细胞（<0.001）和更高的妊娠率（<0.001）显著相关。孕酮升高（≥2 ng/mL）与较薄子宫内膜（<7 mm，<0.007）的较高发生率相关。人绒毛膜促性腺激素（hCG）触发日的雌二醇水平与取出的成熟卵母细胞数量和受精结局呈正相关（<0.05）。成功妊娠的患者孕酮和体重指数较低，而雌二醇、抗苗勒管激素和子宫内膜厚度较高。受试者工作特征曲线（ROC）确定孕酮阈值为1.99 ng/mL，具有中等预测价值。取卵日孕酮水平升高对受精和妊娠结局有负面影响，可能是由于子宫内膜容受性受损。联合评估孕酮、雌二醇、抗苗勒管激素和子宫内膜厚度可能会加强胚胎移植计划并提高IVF成功率。
