A study on the relationship between a novel evaluation parameter of premature luteinisation and IVF outcomes: an analysis of IVF cases over 11 years

Abstract Research Question : Can premature luteinisation of granulosa cells (PLGC) act as a novel parameter of premature luteinisation (PL) and impact in vitro fertilisation (IVF) outcomes? Study Design : Infertility patients undergoing fresh IVF cycles from January 2006 and December 2016 at Reproductive Medicine Center in Tongji Hospital was conducted in this retrospective cohort study. A total of 42,468 cycles were enrolled. Propensity score matching was performed to match the baseline characteristics, and participants were categorised into the PLGC group and control group. The main outcomes were pregnancy rate and live birth rate. Results(s) : Patient characteristics and clinical outcomes were compared before and after matching. In general, the fate of oocytes in the PLGC group was much worse than those in the control group after matching, including MII rate, 2 pronuclei rate, available embryo rate, blastocyst formation rate, high quality blastocyst rate, pregnancy rate, implantation rate and live birth rate. Among those potential risk factors, gonadotropin duration, oestradiol and progesterone on HCG day were positively associated with the occurrence of PLGC in the multivariate logistic regression model, with gonadotropin dosage negatively related. Moreover, cumulus-oocyte complexes (COCs) with PLGC showed a high correlation with elevated progesterone levels over 1.5 ng/mL. Conclusion(s) : Our findings demonstrated the adverse effect of PLGC on oocyte competency. PLGC in COCs evaluation provide an available novel parameter for PL judgement in clinical, and individualised precise treatment, close monitoring of progesterone level as well as critical analysis of progesterone elevation can reduce the occurrence of PL.