Zhiyan Ahmad Abdullah a

a Maternity Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.


Submitted: 20/9/2019; Accepted: 13/9/2020; Published: 21/9/2020

DOI Link: https://doi.org/10.17656/jsmc.10256 



High progesterone (P4) level in the late follicular phase during in vitro fertilization (IVF) - intracytoplasmic sperm injection (ICSI) cycles had been claimed to have associations with decreased pregnancy rate; however, the evidence is still not clear.


The aim was to determine the effect of serum P4 on pregnancy outcomes among IVF-ICSI cycles.

Patients and Methods

The prospective observational study was conducted on 997 patients who underwent IVF-ICSI cycles in the International Private IVF Center in Sulaimani from January 1st, 2017 to January 1st, 2019. Blood samples were collected for serum P4 on the day of the ovulation trigger. Ovum pickup was done 36 hours later, and serum P4 was correlated with IVF-ICSI outcome in terms of positive conception rate. The patients were subdivided into four subgroups depending on different age groups, conception rates and serum P4 were studied in each age group.


The average serum P4 for positive and negative pregnancy groups among patients was 0.766 ng/ml and 0.803 ng/ml, respectively, with a statistically significant difference (P-value=0.035). Also, P4 for positive and negative groups was 0.852 ng/ml and 0.804 ng/ml, respectively, for the age group of 35-39 years (P-value=0.014). 


Pregnancy may still occur with high P4, and the need to identify the subgroup of cycles with elevated P4 does not signify implantation failure or reduction, is still in question. Therefore, more studies are needed before making decisions like freezing all embryo or cycle cancelation based on the level of serum P4 alone.


Intracytoplasmic sperm injection (ICSI); In vitro fertilization (IVF); Kurdistan; Pregnancy; Progesterone (P4); Sulaimani.


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