Early Progesterone Rise in the Follicular Phase: Predictor of Anovulation?

Divaraniya, A., Hills, E., Peyser, A. , Hershlag, A.

Abstract:

This study investigated the role of progesterone levels during the follicular phase. While estradiol and luteinizing hormone are commonly used in evaluating the follicular phase, progesterone is not typically considered until after ovulation in the luteal phase. However, previous studies have noted a rise in progesterone prior to ovulation. We further explored this phenomenon using an at-home quantitative platform to analyze progesterone patterns during the follicular phase.

The study's results showed that the average progesterone peak during the follicular phase was 5.227 ng/mL and remained elevated for an average of 3.278 days. The average progesterone peak did not differ significantly between ovulatory and anovulatory cycles. However, the timing of the progesterone rise showed promise as a potential indicator of whether a cycle would be ovulatory or anovulatory.

Anovulatory cycles had an earlier progesterone rise in the follicular phase, leading to a longer gap between the progesterone rise and LH peak (mean of 6.05 days). In contrast, ovulatory cycles had a progesterone rise occur on average 3.37 days prior to LH peak. This timing difference was statistically significant (p < 0.05), suggesting that the timing of progesterone during the follicular phase could serve as a predictive marker for ovulatory cycles.