Dados do Trabalho

Title

Does elevated progesterone on day of trigger associate with blastocyst ploidy in egg donor cycles?

Objective

Evaluate if high progesterone levels on day of trigger influences blastocyst ploidy and laboratory outcomes in egg donors cycles.

Methods

This retrospective cohort study, performed between April/2013 and February/2019 at Huntington Medicina Reprodutiva Clinic, analyzed laboratory data from ICSI cycles using frozen donated oocytes that underwent embryo biopsy (PGT-A) at blastocyst stage. Patients were divided into two groups according to serum progesterone (P4) on trigger day: group A if P4 <1.5 ng/mL and group B if P4 ≥1.5 ng/mL. Only euploid embryos were transfer on FET cycles. Primary outcome was embryo euploidy and aneuploidy rate. Secondary outcomes were number of blastocysts, number of top quality embryos, number of euploid/aneuploid embryos and clinical pregnancy rate. These parameters were compared between groups A and B. T and Fisher tests were used for statistical analysis.

Results

259 egg donors cycles with PGT-A were analyzed. Group A included 75 cycles (57 donors; 69 recipients) and group B 184 cycles (115 donors; 163 recipients). Group A donors`mean age was 25.15±3.59 and group B 24.46±3.73 years old (p=0.19). Total gonadotropins used and basal FSH were not different between the two groups (2777.83±526.02 vs 2814.54±538.78, p=0.7363; 5.19±1.51 vs 5.22±1.47, p=0.3035). Group B had a significantly higher number of antral follicular count (22.95±10.65 vs 19.60±7.08, p= 0.0301) and estradiol at trigger (5255.00±6405.77 vs 5252.83±4346.33 vs, p=0.0340). Number of eggs retrieved and number of MII were higher in group B than A (33.96±1.76 vs 28.01±11.78, p=0.0014; 24.84±11.74 vs 21.12±10.56, p=0.0082). There were no difference between groups in oocytes post-thaw survival rate and fertilization rate (0.95±0.10 vs 0.98±0.17, p=0.2626; 0.83±0.14 vs 0.82±0.13, p=0.854).
The number of blastocysts (3,60±1,52 vs 3,68±1,52, p=0,667), number of top-quality embryos (2,27±1,59 vs 2,28±1,43, p=0,802), number of euploid embryos (1,92±1,25 vs 1,92±1,13, p=0,954) and number of aneuploid embryos (1,23±1,01 vs 1,14±0,94, p=0,593) were not significantly different between the two groups. Euploid embryo rate (0,31±0,20 vs 0,30±0,18, p=0,626) and aneuploidy embryo rate (0,21±0.19 vs 0,18±0,15, p=0,436) did not significantly differ. There was also no difference in clinical pregnancy rate (0,73 vs 0,82, p= 0,476). Seminal parameters were similar between groups.

Conclusion

Our data showed that elevated progesterone levels on trigger’s day is not associated with blastocyst aneuploidy rates or worst laboratory outcomes in egg donor’s cycles, in which the cofounder of maternal age is excluded from the analysis.

Keywords

Embryo ploidy, egg donor, progesterone, trigger day, PGT-A.