Endocrine mechanisms and assay issues in premature progesterone elevation in assisted reproductive technology

End-controlled ovarian stimulation progesterone elevation has been reported for over 25 years with doubts remaining regarding its pathophysiology and the validity of the progesterone assays used for detecting it.

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Volume 109, Issue 4, Pages 571–576


Dominique de Ziegler, M.D., Clauslaus Yding Andersen, M.D., D.M.Sc., Frank Z. Stanczyk, Ph.D., Jean Marc Ayoubi, M.D.


Progesterone elevation occurring in the late phases of controlled ovarian stimulation (COS) has been reported for over 25 years. Yet doubts remain regarding the mechanisms at play in this phenomenon and its net consequences on assisted reproductive technology outcome, which is known to occur in poor and good assisted reproductive technology responders. The pathophysiology of end-COS progesterone elevation encountered in gonadotropin-suppressed cycles is different from that prevailing at the time of, and just after, ovulation. The different divergence in practical consequences of end-COS progesterone elevation led to review the progesterone assays developed for measuring progesterone in the luteal phase of the menstrual cycle, but commonly used for measuring all forms of progesterone elevation.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.