Follicular fluid progesterone level associated with fertilization outcome during in vitro fertilization: a systematic review and meta-analysis
Follicular fluid (FF) is a key biochemical environment for oocyte development. The potential effect of follicular progesterone level on successful fertilization is a subject of debate, therefore our aim was to give a summary on the currently available evidence on the association between FF progesterone level and fertilization outcome.
To do so, a systematic review and a meta-analysis were performed, with the literature searches being conducted in three databases (PubMed, EMBASE and The Cochrane Library) to identify all relevant studies ever published up till 19 August 2017. Data was available from 13 studies (4 ICSI and 9 conventional IVF) and 1009 individually aspirated FF samples were included in the analysis. The progesterone levels in FF were significantly higher in normal fertilization than in failed fertilization, both in conventional IVF (33 % difference, p<0.001) and ICSI (34% difference, p=0.004.
Although this data shows that fertilized oocytes are derived from follicles with higher levels of progesterone, the results must be interpreted with caution, because of various progesterone measurement methods and different treatment protocols and it is too early to state that FF progesterone level could be considered as a marker for oocyte quality.