Progesterone Priming Modulates Ovarian and Early Embryonic Responses to Intensified Gonadotropin Stimulation in Rats

S
Shaden M. Alotaibi1
S
Saleh H. Alwasel1
1Department of Zoology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia.

Background: The present study investigated the effects of progesterone priming and gonadotropin stimulation intensity on ovarian response and early embryo development during in vitro embryo production (IVEP) in rats.

Methods: Sixty adult female Wistar rats were allocated to four treatment groups (n = 15 per group), with five females from each group included in each of three independent experimental replicates. The groups received either standard or intensified gonadotropin stimulation, with or without progesterone priming. Oocyte recovery, two-cell embryo production and two-cell embryo yield were evaluated.

Result: Intensified gonadotropin stimulation did not significantly alter oocyte recovery in non-primed females, whereas progesterone-primed females subjected to intensified stimulation exhibited the highest oocyte recovery (25.00±5.66 oocytes; P<0.05). This treatment combination also produced the highest number of two-cell embryos (17.60±4.61; P<0.05). Among progesterone-primed females, intensified stimulation significantly increased two-cell embryo yield compared with standard stimulation (70.50±7.63% vs. 47.25±2.91%; P<0.05). These findings indicate that ovarian and early embryonic responses to intensified gonadotropin stimulation may vary according to the endocrine conditions preceding stimulation. Progesterone priming combined with intensified gonadotropin stimulation was associated with increased oocyte recovery and two-cell embryo production, highlighting the importance of optimizing endocrine pretreatment and stimulation intensity during rat IVEP.

Assisted reproductive technologies (ARTs) and in vitro embryo production (IVEP) systems are widely used in reproductive biology to investigate the processes regulating oocyte maturation, fertilization and early embryonic development (Jiang et al., 2023). The efficiency of these systems is strongly influenced by ovarian stimulation protocols designed to maximize follicular recruitment and increase the number of oocytes available for fertilization (Harvey et al., 2025; Vennapureddy et al., 2024). In mammalian species, exogenous gonadotropins such as equine chorionic gonadotropin (eCG) and human chorionic gonadotropin (hCG) are commonly used to stimulate follicular growth and induce ovulation because of their follicle-stimulating hormone (FSH)-like and luteinizing hormone (LH)-like activities, respectively (Behringer et al., 2018). Although gonadotropin-based stimulation protocols increase ovarian responsiveness and oocyte yield, accumulating evidence indicates that excessive hormonal stimulation may alter follicular dynamics and compromise oocyte developmental competence (Bosch et al., 2010; Santos et al., 2010).
       
Developmental competence refers to the ability of an oocyte to undergo successful fertilization and support subsequent embryo development. This capacity depends on coordinated nuclear and cytoplasmic maturation events, including spindle organization, mitochondrial redistribution, maternal mRNA accumulation and metabolic regulation within the follicular microenvironment (Doultani et al., 2022; Ferreira et al., 2009; Gilchrist et al., 2008; Sirard et al., 2006). Importantly, the number of oocytes retrieved following ovarian stimulation does not necessarily reflect their developmental quality (Bera et al., 2025). Supraphysiological gonadotropin exposure has been associated with altered steroidogenesis, asynchronous follicular growth, oxidative stress and disruption of oocyte maturation pathways, which may adversely affect fertilization and subsequent embryo development (Bosch et al., 2010; Santos et al., 2010; Combelles et al., 2009). Conversely, moderate ovarian stimulation may improve follicular recruitment while preserving oocyte competence and developmental potential.
       
In addition to gonadotropin stimulation intensity, endocrine conditions preceding ovarian stimulation may influence follicular responsiveness and subsequent embryo production outcomes. Progesterone pretreatment is used to suppress endogenous reproductive activity and improve coordination of follicular development, thereby promoting a more synchronized ovarian response following gonadotropin administration (Venetis et al., 2013). Experimental and clinical studies suggest that progesterone-mediated endocrine modulation may influence the follicular environment and temporal coordination of follicular maturation, with potential consequences for oocyte competence and subsequent embryo development (Gilchrist et al., 2008; Venetis et al., 2013; Fleming and Jenkins, 2010). However, how progesterone priming interacts with gonadotropin stimulation intensity to influence ovarian response and early embryonic development during IVEP remains insufficiently understood.
       
Previous studies have examined ovarian responses to gonadotropin stimulation, including ovulation and pregnancy outcomes (Santos et al., 2010). However, the combined effects of progesterone priming and stimulation intensity on oocyte recovery and early embryonic development remain insufficiently characterized, particularly in rats. Moreover, increased ovarian responsiveness does not necessarily translate into improved developmental outcomes  (Baart et al., 2007). Evaluating these combined effects may help clarify the relationship between oocyte recovery and early embryo production. The rat provides a well-established experimental model for investigating ovarian physiology, follicular responses to exogenous gonadotropins and early embryonic development under controlled endocrine conditions. Examining the combined effects of progesterone priming and gonadotropin stimulation intensity in this model may therefore provide insight into how the endocrine environment preceding ovarian stimulation influences the balance between oocyte yield and subsequent early developmental outcomes. However, the applicability of findings from rats to other mammalian species requires further investigation. Therefore, the present study aimed to evaluate the effects of progesterone priming and gonadotropin stimulation intensity on oocyte recovery, two-cell embryo production and two-cell embryo yield during in vitro embryo production in rats. We hypothesized that progesterone priming and gonadotropin stimulation intensity would be associated with differential ovarian and early embryonic responses, as reflected by differences in oocyte recovery, two-cell embryo production and two-cell embryo yield.
Experimental animals

Nine adult male and sixty adult female Wistar rats (Rattus norvegicus albinus) were obtained from the Animal House Facility, Department of Zoology, King Saud University, Riyadh, Saudi Arabia. The initial body weights were 300±20 g for males and 180±20 g for females. Before the initiation of the experiment, animals were acclimatized for one week under standardized laboratory conditions maintained at 22±2°C with a controlled 12 h light:12 h dark cycle. Animals had ad libitum access to tap water and a standard laboratory pellet diet throughout the experimental period.
       
All animal procedures were approved by the Institutional Animal Care and Use Committee (IACUC), King Saud University, Riyadh, Saudi Arabia (Approval No. KSU-SE-23-123; approved on 24 January 2024) and were conducted in accordance with applicable institutional guidelines for the care and use of laboratory animals. The study was conducted and reported in accordance with the ARRIVE 2.0 guidelines and the principles of Replacement, Reduction and Refinement (3Rs). All experimental procedures were designed to minimize animal distress and unnecessary animal use.
 
Hormonal treatments and ovarian stimulation protocol
 
Progesterone (P4-300®, 4-pregnane-3,20-dione; Botupharma, Brazil) was used for progesterone priming before gonadotropin stimulation. Equine chorionic gonadotropin (eCG; Syncropart®, Ceva Animal Health, France), which exhibits follicle-stimulating hormone-like activity, was administered to stimulate follicular recruitment and growth, whereas human chorionic gonadotropin (hCG; Chorulon®, Merck Animal Health, USA), which exhibits luteinizing hormone-like activity, was used to induce ovulation.
       
For progesterone priming, females received subcutaneous progesterone injections at a dose of 5 mg/kg body weight once daily for five consecutive days (Brown-Grant, 1967). The first eCG injection was administered 24 h after the final progesterone injection. Superovulation was subsequently induced by intraperitoneal administration of eCG followed 48 h later by hCG. Under the standard gonadotropin stimulation protocol, females received 150 IU/kg eCG followed by 75 IU/kg hCG. Under the intensified gonadotropin stimulation protocol, females received fixed doses of 100 IU eCG and 50 IU hCG per animal, irrespective of body weight (Cornejo-Cortés et al., 2006; Kon et al., 2014).
       
For experimental standardization, Day 0 was defined as the day of oocyte collection for in vitro fertilization (IVF), whereas negative days represented time points preceding IVF. To minimize circadian variation, hormonal administrations were performed at 10:00 a.m. According to the superovulation schedule, eCG was administered on Day -3, followed by hCG on Day -1, 48 h later. Oocyte collection was performed at 6:00 a.m. on Day 0, approximately 20 h after hCG administration, corresponding to the expected time of ovulation (Aoto et al., 2011).
 
Experimental design
 
Sixty adult female rats were randomly allocated to two experimental groups according to progesterone priming before in vitro embryo production. Females in the first group received gonadotropin stimulation without progesterone priming, whereas females in the second group received progesterone priming before gonadotropin stimulation. Within each group, females were further assigned to either the standard or intensified gonadotropin stimulation protocol described above.
       
A 2 × 2 factorial experimental design was used to evaluate the effects of progesterone priming and gonadotropin stimulation intensity. Accordingly, four treatment subgroups were established: CTRL (standard gonadotropin stimulation), OVD (intensified gonadotropin stimulation), P-CTRL (progesterone priming with standard gonadotropin stimulation) and P-OVD (progesterone priming with intensified gonadotropin stimulation). Each treatment group comprised 15 females distributed equally across three independent experimental replicates, with five females per treatment group in each replicate (20 females per replicate).
       
The experimental groups, hormonal treatment protocols and administration timing are summarized in Table 1.

Table 1: Experimental groups, hormonal treatment protocols and administration timing in rats.


 
In vitro embryo production (IVEP)
 
Media preparation
 
Modified Human Tubal Fluid (mHTF) medium was used for gamete collection and fertilization procedures. The medium consisted of 94.6 mM NaCl, 4.78 mM KCl, 1.71 mM CaCl2, 1.19 mM KH2PO4, 1.19 mM MgSO4, 25.07 mM NaHCO3, 21.58 mM sodium lactate, 0.5 mM sodium pyruvate, 5.56 mM glucose, 4.0 mg/mL bovine serum albumin (BSA), 50 µg/mL streptomycin sulfate and 75 µg/mL potassium penicillin G (Kito et al., 2004).
       
Modified potassium simplex optimized medium (mKSOM) was used for embryo culture following fertilization. The medium contained 95 mM NaCl, 5 mM KCl, 1.71 mM CaCl2·2H2O, 0.2 mM MgSO4·7H2O, 25.0 mM NaHCO3, 10.0 mM sodium lactate, 0.2 mM sodium pyruvate, 0.2 mM glucose, 0.01 mM EDTA, 1× minimum essential amino acid solution, 1 mM glutamine, 1× MEM non-essential amino acid solution, 1 mM taurine, 1 mM glycine, 1 mM glutamate, 1 mM alanine and 1 mg/mL BSA (Men et al., 2023).
 
Oocyte collection
 
Females were euthanized by CO2  inhalation approximately 20 h after hCG administration. Both oviductal ampullae were carefully dissected and transferred into mHTF droplets under paraffin oil. A small incision was made in the ampullary wall using an insulin syringe needle to release the cumulus-oocyte complexes (COCs) into the medium (Aoto et al., 2011; Men et al., 2023; Oh et al., 1998).
       
Following recovery, COCs were collected and counted under a stereomicroscope before fertilization. The total number of oocytes recovered from each female was recorded as a measure of ovarian response.
       
Oocytes from each female were collected, counted, fertilized and cultured separately, without pooling between females or treatment groups. Oocyte yield and subsequent embryo development were recorded individually for each female, which served as the experimental unit for all outcome measurements.
 
Sperm collection and in vitro fertilization
 
Adult male rats were euthanized by CO2 inhalation on the morning of the experiment. The cauda epididymides were carefully excised, trimmed of surrounding fat and connective tissue and transferred into mHTF droplets under paraffin oil. Small incisions were made in the cauda epididymides using micro-spring scissors to release spermatozoa into the fertilization medium (Aoto et al., 2011; Men et al., 2023; Miyoshi et al., 1997). In each of the three independent experimental replicates, spermatozoa from three different males were pooled into a single sample. The same pooled sperm suspension was used to inseminate oocytes from all four treatment groups (CTRL, OVD, P-CTRL and P-OVD) within each replicate, ensuring a common sperm source across treatments.
       
Following sperm release, the sperm concentration was determined and adjusted to a final concentration of 1 × 106 sperm/mL in the COC-containing fertilization droplets. Before insemination, the sperm suspension was incubated for approximately 60 min at 37°C under 5% CO2 to allow capacitation. The fertilization dishes were then incubated at 37°C under 5% CO2 for approximately 12 h (Aoto et al., 2011; Men et al., 2023; Miyoshi et al., 1997).
 
Embryo culture and developmental assessment
 
Following the fertilization period, all oocytes were transferred to mHTF medium supplemented with 1% hyaluronidase and the surrounding cumulus cells were removed using glass Pasteur pipettes. Denuded oocytes were washed twice in fresh mKSOM medium (Aoto et al., 2011; Men et al., 2023) and then cultured in mKSOM medium at 37°C under 5% CO2 for 24 h. Early embryonic development was assessed by recording the number of embryos that reached the two-cell stage.
       
Two-cell embryo yield was calculated using the following equation:

 
Two-cell embryo yield was calculated separately for each female by dividing the number of two-cell embryos by the total number of oocytes recovered from that female. The mean yield for each treatment group was then calculated from the individual percentages of the 15 females, rather than from pooled oocyte totals.
 
Statistical analysis
 
Statistical analyses were performed using IBM SPSS Statistics software (version 29.0; IBM Corp., Armonk, NY, USA). Data were assessed for normality and homogeneity of variance using the Shapiro-Wilk and Levene’s tests, respectively and are presented as mean ± standard deviation (SD).
       
The effects of progesterone priming and gonadotropin stimulation intensity on oocyte recovery and two-cell embryo production were analyzed using two-way analysis of variance (ANOVA), with progesterone priming (absence or presence) and gonadotropin stimulation intensity (standard or intensified) as fixed factors. The interaction between progesterone priming and stimulation intensity was included in the model. When appropriate, pairwise comparisons among the four treatment groups were performed using Tukey’s post hoc test. Statistical significance was set at P<0.05.
       
Two-cell embryo yield was calculated as the proportion of two-cell embryos relative to the total number of recovered oocytes and analyzed using a generalized linear model (GLM) with a binomial distribution and logit link function. The model included progesterone priming, stimulation intensity and their interaction as fixed effects.
Ovarian response and oocyte yield
 
Oocyte recovery differed among the four treatment groups (Fig 1). Under standard gonadotropin stimulation, non-primed females (CTRL) yielded 16.33±4.25 oocytes, whereas progesterone-primed females (P-CTRL) yielded 15.06±2.73 oocytes. Intensified gonadotropin stimulation did not significantly alter oocyte recovery in non-primed females (OVD; 17.80±1.32 oocytes), whereas progesterone-primed females subjected to intensified stimulation (P-OVD) exhibited the highest oocyte recovery among the four treatment groups (25.00±5.66 oocytes; P<0.05).

Fig 1: Effect of progesterone priming and gonadotropin stimulation intensity on oocyte yield in rats.


       
Two-way ANOVA revealed significant main effects of progesterone priming (F(1, 56) = 8.879, P = 0.004) and gonadotropin stimulation intensity [F(1, 56) = 32.776, P<0.001], as well as a significant interaction between these factors [F(1, 56) = 18.079, P<0.001].
 
Early embryonic development
 
The number of embryos reaching the two-cell stage differed significantly among treatment groups (Fig 2). Under standard gonadotropin stimulation, progesterone-primed females (P-CTRL) produced significantly fewer two-cell embryos (7.13±1.41) than non-primed females (CTRL; 11.26±4.19; P<0.05). Non-primed females subjected to intensified gonadotropin stimulation (OVD) produced 12.73±1.62 two-cell embryos. Progesterone-primed females subjected to intensified stimulation (P-OVD) produced the highest number of two-cell embryos among the four treatment groups (17.60±4.61; P<0.05). Representative two-cell embryos obtained following in vitro fertilization and embryo culture are shown in Fig 3.

Fig 2: Effect of progesterone priming and gonadotropin stimulation intensity on early embryo development in rats.



Fig 3: Photomicrograph of rat embryos at the two-cell stage following in vitro fertilization and culture in mKSOM medium.


       
Two-way ANOVA showed no significant main effect of progesterone priming on two-cell embryo count (F(1, 56) = 0.185, P = 0.668), whereas gonadotropin stimulation intensity (F(1, 56) = 49.089, P<0.001) and the interaction between progesterone priming and stimulation intensity (F(1, 56) = 27.922, P<0.001) were significant.
 
Two-cell embryo yield
 
Two-cell embryo yield differed among treatment groups (Fig 4). Under standard gonadotropin stimulation, CTRL and P-CTRL females exhibited two-cell embryo yields of 66.63±11.13% and 47.25±2.91%, respectively. Under intensified gonadotropin stimulation, two-cell embryo yield was 71.44±6.88% in non-primed females (OVD) and 70.50±7.63% in progesterone-primed females (P-OVD). Among progesterone-primed females, intensified gonadotropin stimulation resulted in a significantly higher two-cell embryo yield than standard stimulation (P<0.05). Binomial generalized linear model analysis revealed significant effects of progesterone priming [Wald χ2(1) = 13.566, P<0.001], gonadotropin stimulation intensity [Wald χ2(1) = 17.632, P<0.001] and their interaction [Wald χ2(1) = 10.631, P = 0.001] on two-cell embryo yield.

Fig 4: Effect of progesterone priming and gonadotropin stimulation intensity on two-cell embryo yield in rats.


       
The present study shows that progesterone priming and gonadotropin stimulation intensity are associated with distinct ovarian and early embryonic responses during in vitro embryo production in rats. Progesterone-primed females subjected to intensified gonadotropin stimulation exhibited the highest oocyte recovery and the highest number of embryos reaching the two-cell stage. Early embryonic cleavage following in vitro fertilization has also been investigated in buffalo oocytes (Pitroda et al., 2024). Moreover, intensified stimulation significantly increased two-cell embryo yield compared with standard stimulation in progesterone-primed females. These findings indicate that the ovarian and early embryonic responses to gonadotropin stimulation may vary according to the endocrine conditions preceding stimulation.
       
Oocyte yield is a major indicator of ovarian responsiveness during superovulation and reflects the ability of ovarian follicles to respond to exogenous gonadotropins (Adams et al., 2008; Liu et al., 2023; Poulain et al., 2021). In the present study, intensified gonadotropin stimulation did not significantly alter oocyte recovery in non-primed females, whereas progesterone-primed females subjected to intensified stimulation exhibited the highest oocyte yield. Progesterone pretreatment has been reported to promote coordinated follicular development and improve the uniformity of follicular recruitment following exogenous stimulation (Bó et al., 2003; Dong et al., 2021; Kobanawa, 2025). Such endocrine modulation may contribute to the greater ovarian response observed when progesterone priming was followed by intensified gonadotropin stimulation.
       
The relationship between increased oocyte yield and subsequent early embryonic development remains biologically complex. Successful embryo development depends on the acquisition of oocyte developmental competence through coordinated nuclear and cytoplasmic maturation processes, including spindle organization, mitochondrial redistribution, maternal transcript accumulation and metabolic regulation within the follicular microenvironment (Coticchio et al., 2015; Gilchrist et al., 2008). Although excessive gonadotropin exposure has been associated with altered follicular dynamics and reduced oocyte quality (Santos et al., 2010), the present findings suggest that the early embryonic response to intensified gonadotropin stimulation may vary according to the endocrine conditions preceding ovarian stimulation.
       
A notable finding of the present study was the significantly higher two-cell embryo yield in progesterone-primed females receiving intensified rather than standard gonadotropin stimulation. This treatment combination also produced the highest number of embryos reaching the two-cell stage. Progesterone priming has been proposed to improve the coordination of follicular maturation and reduce variability in oocyte developmental status (Bó et al., 2003), which may contribute to the observed differences in early embryo production.
       
Interestingly, the increased oocyte recovery and two-cell embryo production observed under intensified gonadotropin stimulation differ from the detrimental reproductive outcomes reported under excessive hormonal stimulation in vivo. Previous studies have shown that supraphysiological ovarian stimulation may impair uterine receptivity and implantation despite increasing ovarian activity (Kalakota et al., 2022; Santos et al., 2010). This distinction highlights the difference between enhanced ovarian and early embryonic responses observed in vitro and the broader reproductive processes required for successful pregnancy establishment in vivo.
       
Nevertheless, the longer-term developmental consequences of intensified gonadotropin stimulation remain uncertain because embryonic development was evaluated only up to the two-cell stage, without assessing subsequent blastocyst development or pregnancy outcomes. Therefore, the present findings should be interpreted as reflecting early embryonic development rather than subsequent developmental competence. Further studies extending embryo culture to the blastocyst stage and evaluating implantation potential, together with molecular and cellular markers of oocyte and embryo quality, are warranted.
Progesterone priming combined with intensified gonadotropin stimulation resulted in the highest oocyte recovery and two-cell embryo production in rats. Intensified stimulation also significantly increased two-cell embryo yield in progesterone-primed females compared with standard stimulation. These findings suggest that endocrine pretreatment may influence ovarian and early embryonic responses to gonadotropin stimulation and highlight the importance of optimizing hormonal protocols for in vitro embryo production. Further studies are needed to determine whether the observed differences in early embryonic development translate into improved developmental competence and reproductive success.
The authors extend their appreciation to the Ongoing Research Funding Program (ORF-2026-811), King Saud University, Riyadh, Saudi Arabia, for funding this work. The authors also thank the staff of the Animal House Facility, Department of Zoology, King Saud University, for their technical support and assistance with animal care.
 
Funding
 
This work was supported by the Ongoing Research Funding Program (ORF-2026-811), King Saud University, Riyadh, Saudi Arabia.
 
Author contributions
 
Muath Q. Al-Ghadi conceived and designed the study and supervised the research. Shaden M. Alotaibi performed the experiments, conducted the laboratory procedures and collected the data. Shaden M. Alotaibi and Muath Q. Al-Ghadi analyzed and interpreted the data. Muath Q. Al-Ghadi provided methodological guidance. Saleh H. Alwasel contributed to study supervision and critically reviewed the manuscript. Shaden Madhi Alotaibi prepared the original draft of the manuscript. Muath Q. Al-Ghadi and Saleh H. Alwasel reviewed and revised the manuscript for important intellectual content. All authors read and approved the final version of the manuscript.
 
Data availability statement
 
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
The authors declare no competing interests.

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Progesterone Priming Modulates Ovarian and Early Embryonic Responses to Intensified Gonadotropin Stimulation in Rats

S
Shaden M. Alotaibi1
S
Saleh H. Alwasel1
1Department of Zoology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia.

Background: The present study investigated the effects of progesterone priming and gonadotropin stimulation intensity on ovarian response and early embryo development during in vitro embryo production (IVEP) in rats.

Methods: Sixty adult female Wistar rats were allocated to four treatment groups (n = 15 per group), with five females from each group included in each of three independent experimental replicates. The groups received either standard or intensified gonadotropin stimulation, with or without progesterone priming. Oocyte recovery, two-cell embryo production and two-cell embryo yield were evaluated.

Result: Intensified gonadotropin stimulation did not significantly alter oocyte recovery in non-primed females, whereas progesterone-primed females subjected to intensified stimulation exhibited the highest oocyte recovery (25.00±5.66 oocytes; P<0.05). This treatment combination also produced the highest number of two-cell embryos (17.60±4.61; P<0.05). Among progesterone-primed females, intensified stimulation significantly increased two-cell embryo yield compared with standard stimulation (70.50±7.63% vs. 47.25±2.91%; P<0.05). These findings indicate that ovarian and early embryonic responses to intensified gonadotropin stimulation may vary according to the endocrine conditions preceding stimulation. Progesterone priming combined with intensified gonadotropin stimulation was associated with increased oocyte recovery and two-cell embryo production, highlighting the importance of optimizing endocrine pretreatment and stimulation intensity during rat IVEP.

Assisted reproductive technologies (ARTs) and in vitro embryo production (IVEP) systems are widely used in reproductive biology to investigate the processes regulating oocyte maturation, fertilization and early embryonic development (Jiang et al., 2023). The efficiency of these systems is strongly influenced by ovarian stimulation protocols designed to maximize follicular recruitment and increase the number of oocytes available for fertilization (Harvey et al., 2025; Vennapureddy et al., 2024). In mammalian species, exogenous gonadotropins such as equine chorionic gonadotropin (eCG) and human chorionic gonadotropin (hCG) are commonly used to stimulate follicular growth and induce ovulation because of their follicle-stimulating hormone (FSH)-like and luteinizing hormone (LH)-like activities, respectively (Behringer et al., 2018). Although gonadotropin-based stimulation protocols increase ovarian responsiveness and oocyte yield, accumulating evidence indicates that excessive hormonal stimulation may alter follicular dynamics and compromise oocyte developmental competence (Bosch et al., 2010; Santos et al., 2010).
       
Developmental competence refers to the ability of an oocyte to undergo successful fertilization and support subsequent embryo development. This capacity depends on coordinated nuclear and cytoplasmic maturation events, including spindle organization, mitochondrial redistribution, maternal mRNA accumulation and metabolic regulation within the follicular microenvironment (Doultani et al., 2022; Ferreira et al., 2009; Gilchrist et al., 2008; Sirard et al., 2006). Importantly, the number of oocytes retrieved following ovarian stimulation does not necessarily reflect their developmental quality (Bera et al., 2025). Supraphysiological gonadotropin exposure has been associated with altered steroidogenesis, asynchronous follicular growth, oxidative stress and disruption of oocyte maturation pathways, which may adversely affect fertilization and subsequent embryo development (Bosch et al., 2010; Santos et al., 2010; Combelles et al., 2009). Conversely, moderate ovarian stimulation may improve follicular recruitment while preserving oocyte competence and developmental potential.
       
In addition to gonadotropin stimulation intensity, endocrine conditions preceding ovarian stimulation may influence follicular responsiveness and subsequent embryo production outcomes. Progesterone pretreatment is used to suppress endogenous reproductive activity and improve coordination of follicular development, thereby promoting a more synchronized ovarian response following gonadotropin administration (Venetis et al., 2013). Experimental and clinical studies suggest that progesterone-mediated endocrine modulation may influence the follicular environment and temporal coordination of follicular maturation, with potential consequences for oocyte competence and subsequent embryo development (Gilchrist et al., 2008; Venetis et al., 2013; Fleming and Jenkins, 2010). However, how progesterone priming interacts with gonadotropin stimulation intensity to influence ovarian response and early embryonic development during IVEP remains insufficiently understood.
       
Previous studies have examined ovarian responses to gonadotropin stimulation, including ovulation and pregnancy outcomes (Santos et al., 2010). However, the combined effects of progesterone priming and stimulation intensity on oocyte recovery and early embryonic development remain insufficiently characterized, particularly in rats. Moreover, increased ovarian responsiveness does not necessarily translate into improved developmental outcomes  (Baart et al., 2007). Evaluating these combined effects may help clarify the relationship between oocyte recovery and early embryo production. The rat provides a well-established experimental model for investigating ovarian physiology, follicular responses to exogenous gonadotropins and early embryonic development under controlled endocrine conditions. Examining the combined effects of progesterone priming and gonadotropin stimulation intensity in this model may therefore provide insight into how the endocrine environment preceding ovarian stimulation influences the balance between oocyte yield and subsequent early developmental outcomes. However, the applicability of findings from rats to other mammalian species requires further investigation. Therefore, the present study aimed to evaluate the effects of progesterone priming and gonadotropin stimulation intensity on oocyte recovery, two-cell embryo production and two-cell embryo yield during in vitro embryo production in rats. We hypothesized that progesterone priming and gonadotropin stimulation intensity would be associated with differential ovarian and early embryonic responses, as reflected by differences in oocyte recovery, two-cell embryo production and two-cell embryo yield.
Experimental animals

Nine adult male and sixty adult female Wistar rats (Rattus norvegicus albinus) were obtained from the Animal House Facility, Department of Zoology, King Saud University, Riyadh, Saudi Arabia. The initial body weights were 300±20 g for males and 180±20 g for females. Before the initiation of the experiment, animals were acclimatized for one week under standardized laboratory conditions maintained at 22±2°C with a controlled 12 h light:12 h dark cycle. Animals had ad libitum access to tap water and a standard laboratory pellet diet throughout the experimental period.
       
All animal procedures were approved by the Institutional Animal Care and Use Committee (IACUC), King Saud University, Riyadh, Saudi Arabia (Approval No. KSU-SE-23-123; approved on 24 January 2024) and were conducted in accordance with applicable institutional guidelines for the care and use of laboratory animals. The study was conducted and reported in accordance with the ARRIVE 2.0 guidelines and the principles of Replacement, Reduction and Refinement (3Rs). All experimental procedures were designed to minimize animal distress and unnecessary animal use.
 
Hormonal treatments and ovarian stimulation protocol
 
Progesterone (P4-300®, 4-pregnane-3,20-dione; Botupharma, Brazil) was used for progesterone priming before gonadotropin stimulation. Equine chorionic gonadotropin (eCG; Syncropart®, Ceva Animal Health, France), which exhibits follicle-stimulating hormone-like activity, was administered to stimulate follicular recruitment and growth, whereas human chorionic gonadotropin (hCG; Chorulon®, Merck Animal Health, USA), which exhibits luteinizing hormone-like activity, was used to induce ovulation.
       
For progesterone priming, females received subcutaneous progesterone injections at a dose of 5 mg/kg body weight once daily for five consecutive days (Brown-Grant, 1967). The first eCG injection was administered 24 h after the final progesterone injection. Superovulation was subsequently induced by intraperitoneal administration of eCG followed 48 h later by hCG. Under the standard gonadotropin stimulation protocol, females received 150 IU/kg eCG followed by 75 IU/kg hCG. Under the intensified gonadotropin stimulation protocol, females received fixed doses of 100 IU eCG and 50 IU hCG per animal, irrespective of body weight (Cornejo-Cortés et al., 2006; Kon et al., 2014).
       
For experimental standardization, Day 0 was defined as the day of oocyte collection for in vitro fertilization (IVF), whereas negative days represented time points preceding IVF. To minimize circadian variation, hormonal administrations were performed at 10:00 a.m. According to the superovulation schedule, eCG was administered on Day -3, followed by hCG on Day -1, 48 h later. Oocyte collection was performed at 6:00 a.m. on Day 0, approximately 20 h after hCG administration, corresponding to the expected time of ovulation (Aoto et al., 2011).
 
Experimental design
 
Sixty adult female rats were randomly allocated to two experimental groups according to progesterone priming before in vitro embryo production. Females in the first group received gonadotropin stimulation without progesterone priming, whereas females in the second group received progesterone priming before gonadotropin stimulation. Within each group, females were further assigned to either the standard or intensified gonadotropin stimulation protocol described above.
       
A 2 × 2 factorial experimental design was used to evaluate the effects of progesterone priming and gonadotropin stimulation intensity. Accordingly, four treatment subgroups were established: CTRL (standard gonadotropin stimulation), OVD (intensified gonadotropin stimulation), P-CTRL (progesterone priming with standard gonadotropin stimulation) and P-OVD (progesterone priming with intensified gonadotropin stimulation). Each treatment group comprised 15 females distributed equally across three independent experimental replicates, with five females per treatment group in each replicate (20 females per replicate).
       
The experimental groups, hormonal treatment protocols and administration timing are summarized in Table 1.

Table 1: Experimental groups, hormonal treatment protocols and administration timing in rats.


 
In vitro embryo production (IVEP)
 
Media preparation
 
Modified Human Tubal Fluid (mHTF) medium was used for gamete collection and fertilization procedures. The medium consisted of 94.6 mM NaCl, 4.78 mM KCl, 1.71 mM CaCl2, 1.19 mM KH2PO4, 1.19 mM MgSO4, 25.07 mM NaHCO3, 21.58 mM sodium lactate, 0.5 mM sodium pyruvate, 5.56 mM glucose, 4.0 mg/mL bovine serum albumin (BSA), 50 µg/mL streptomycin sulfate and 75 µg/mL potassium penicillin G (Kito et al., 2004).
       
Modified potassium simplex optimized medium (mKSOM) was used for embryo culture following fertilization. The medium contained 95 mM NaCl, 5 mM KCl, 1.71 mM CaCl2·2H2O, 0.2 mM MgSO4·7H2O, 25.0 mM NaHCO3, 10.0 mM sodium lactate, 0.2 mM sodium pyruvate, 0.2 mM glucose, 0.01 mM EDTA, 1× minimum essential amino acid solution, 1 mM glutamine, 1× MEM non-essential amino acid solution, 1 mM taurine, 1 mM glycine, 1 mM glutamate, 1 mM alanine and 1 mg/mL BSA (Men et al., 2023).
 
Oocyte collection
 
Females were euthanized by CO2  inhalation approximately 20 h after hCG administration. Both oviductal ampullae were carefully dissected and transferred into mHTF droplets under paraffin oil. A small incision was made in the ampullary wall using an insulin syringe needle to release the cumulus-oocyte complexes (COCs) into the medium (Aoto et al., 2011; Men et al., 2023; Oh et al., 1998).
       
Following recovery, COCs were collected and counted under a stereomicroscope before fertilization. The total number of oocytes recovered from each female was recorded as a measure of ovarian response.
       
Oocytes from each female were collected, counted, fertilized and cultured separately, without pooling between females or treatment groups. Oocyte yield and subsequent embryo development were recorded individually for each female, which served as the experimental unit for all outcome measurements.
 
Sperm collection and in vitro fertilization
 
Adult male rats were euthanized by CO2 inhalation on the morning of the experiment. The cauda epididymides were carefully excised, trimmed of surrounding fat and connective tissue and transferred into mHTF droplets under paraffin oil. Small incisions were made in the cauda epididymides using micro-spring scissors to release spermatozoa into the fertilization medium (Aoto et al., 2011; Men et al., 2023; Miyoshi et al., 1997). In each of the three independent experimental replicates, spermatozoa from three different males were pooled into a single sample. The same pooled sperm suspension was used to inseminate oocytes from all four treatment groups (CTRL, OVD, P-CTRL and P-OVD) within each replicate, ensuring a common sperm source across treatments.
       
Following sperm release, the sperm concentration was determined and adjusted to a final concentration of 1 × 106 sperm/mL in the COC-containing fertilization droplets. Before insemination, the sperm suspension was incubated for approximately 60 min at 37°C under 5% CO2 to allow capacitation. The fertilization dishes were then incubated at 37°C under 5% CO2 for approximately 12 h (Aoto et al., 2011; Men et al., 2023; Miyoshi et al., 1997).
 
Embryo culture and developmental assessment
 
Following the fertilization period, all oocytes were transferred to mHTF medium supplemented with 1% hyaluronidase and the surrounding cumulus cells were removed using glass Pasteur pipettes. Denuded oocytes were washed twice in fresh mKSOM medium (Aoto et al., 2011; Men et al., 2023) and then cultured in mKSOM medium at 37°C under 5% CO2 for 24 h. Early embryonic development was assessed by recording the number of embryos that reached the two-cell stage.
       
Two-cell embryo yield was calculated using the following equation:

 
Two-cell embryo yield was calculated separately for each female by dividing the number of two-cell embryos by the total number of oocytes recovered from that female. The mean yield for each treatment group was then calculated from the individual percentages of the 15 females, rather than from pooled oocyte totals.
 
Statistical analysis
 
Statistical analyses were performed using IBM SPSS Statistics software (version 29.0; IBM Corp., Armonk, NY, USA). Data were assessed for normality and homogeneity of variance using the Shapiro-Wilk and Levene’s tests, respectively and are presented as mean ± standard deviation (SD).
       
The effects of progesterone priming and gonadotropin stimulation intensity on oocyte recovery and two-cell embryo production were analyzed using two-way analysis of variance (ANOVA), with progesterone priming (absence or presence) and gonadotropin stimulation intensity (standard or intensified) as fixed factors. The interaction between progesterone priming and stimulation intensity was included in the model. When appropriate, pairwise comparisons among the four treatment groups were performed using Tukey’s post hoc test. Statistical significance was set at P<0.05.
       
Two-cell embryo yield was calculated as the proportion of two-cell embryos relative to the total number of recovered oocytes and analyzed using a generalized linear model (GLM) with a binomial distribution and logit link function. The model included progesterone priming, stimulation intensity and their interaction as fixed effects.
Ovarian response and oocyte yield
 
Oocyte recovery differed among the four treatment groups (Fig 1). Under standard gonadotropin stimulation, non-primed females (CTRL) yielded 16.33±4.25 oocytes, whereas progesterone-primed females (P-CTRL) yielded 15.06±2.73 oocytes. Intensified gonadotropin stimulation did not significantly alter oocyte recovery in non-primed females (OVD; 17.80±1.32 oocytes), whereas progesterone-primed females subjected to intensified stimulation (P-OVD) exhibited the highest oocyte recovery among the four treatment groups (25.00±5.66 oocytes; P<0.05).

Fig 1: Effect of progesterone priming and gonadotropin stimulation intensity on oocyte yield in rats.


       
Two-way ANOVA revealed significant main effects of progesterone priming (F(1, 56) = 8.879, P = 0.004) and gonadotropin stimulation intensity [F(1, 56) = 32.776, P<0.001], as well as a significant interaction between these factors [F(1, 56) = 18.079, P<0.001].
 
Early embryonic development
 
The number of embryos reaching the two-cell stage differed significantly among treatment groups (Fig 2). Under standard gonadotropin stimulation, progesterone-primed females (P-CTRL) produced significantly fewer two-cell embryos (7.13±1.41) than non-primed females (CTRL; 11.26±4.19; P<0.05). Non-primed females subjected to intensified gonadotropin stimulation (OVD) produced 12.73±1.62 two-cell embryos. Progesterone-primed females subjected to intensified stimulation (P-OVD) produced the highest number of two-cell embryos among the four treatment groups (17.60±4.61; P<0.05). Representative two-cell embryos obtained following in vitro fertilization and embryo culture are shown in Fig 3.

Fig 2: Effect of progesterone priming and gonadotropin stimulation intensity on early embryo development in rats.



Fig 3: Photomicrograph of rat embryos at the two-cell stage following in vitro fertilization and culture in mKSOM medium.


       
Two-way ANOVA showed no significant main effect of progesterone priming on two-cell embryo count (F(1, 56) = 0.185, P = 0.668), whereas gonadotropin stimulation intensity (F(1, 56) = 49.089, P<0.001) and the interaction between progesterone priming and stimulation intensity (F(1, 56) = 27.922, P<0.001) were significant.
 
Two-cell embryo yield
 
Two-cell embryo yield differed among treatment groups (Fig 4). Under standard gonadotropin stimulation, CTRL and P-CTRL females exhibited two-cell embryo yields of 66.63±11.13% and 47.25±2.91%, respectively. Under intensified gonadotropin stimulation, two-cell embryo yield was 71.44±6.88% in non-primed females (OVD) and 70.50±7.63% in progesterone-primed females (P-OVD). Among progesterone-primed females, intensified gonadotropin stimulation resulted in a significantly higher two-cell embryo yield than standard stimulation (P<0.05). Binomial generalized linear model analysis revealed significant effects of progesterone priming [Wald χ2(1) = 13.566, P<0.001], gonadotropin stimulation intensity [Wald χ2(1) = 17.632, P<0.001] and their interaction [Wald χ2(1) = 10.631, P = 0.001] on two-cell embryo yield.

Fig 4: Effect of progesterone priming and gonadotropin stimulation intensity on two-cell embryo yield in rats.


       
The present study shows that progesterone priming and gonadotropin stimulation intensity are associated with distinct ovarian and early embryonic responses during in vitro embryo production in rats. Progesterone-primed females subjected to intensified gonadotropin stimulation exhibited the highest oocyte recovery and the highest number of embryos reaching the two-cell stage. Early embryonic cleavage following in vitro fertilization has also been investigated in buffalo oocytes (Pitroda et al., 2024). Moreover, intensified stimulation significantly increased two-cell embryo yield compared with standard stimulation in progesterone-primed females. These findings indicate that the ovarian and early embryonic responses to gonadotropin stimulation may vary according to the endocrine conditions preceding stimulation.
       
Oocyte yield is a major indicator of ovarian responsiveness during superovulation and reflects the ability of ovarian follicles to respond to exogenous gonadotropins (Adams et al., 2008; Liu et al., 2023; Poulain et al., 2021). In the present study, intensified gonadotropin stimulation did not significantly alter oocyte recovery in non-primed females, whereas progesterone-primed females subjected to intensified stimulation exhibited the highest oocyte yield. Progesterone pretreatment has been reported to promote coordinated follicular development and improve the uniformity of follicular recruitment following exogenous stimulation (Bó et al., 2003; Dong et al., 2021; Kobanawa, 2025). Such endocrine modulation may contribute to the greater ovarian response observed when progesterone priming was followed by intensified gonadotropin stimulation.
       
The relationship between increased oocyte yield and subsequent early embryonic development remains biologically complex. Successful embryo development depends on the acquisition of oocyte developmental competence through coordinated nuclear and cytoplasmic maturation processes, including spindle organization, mitochondrial redistribution, maternal transcript accumulation and metabolic regulation within the follicular microenvironment (Coticchio et al., 2015; Gilchrist et al., 2008). Although excessive gonadotropin exposure has been associated with altered follicular dynamics and reduced oocyte quality (Santos et al., 2010), the present findings suggest that the early embryonic response to intensified gonadotropin stimulation may vary according to the endocrine conditions preceding ovarian stimulation.
       
A notable finding of the present study was the significantly higher two-cell embryo yield in progesterone-primed females receiving intensified rather than standard gonadotropin stimulation. This treatment combination also produced the highest number of embryos reaching the two-cell stage. Progesterone priming has been proposed to improve the coordination of follicular maturation and reduce variability in oocyte developmental status (Bó et al., 2003), which may contribute to the observed differences in early embryo production.
       
Interestingly, the increased oocyte recovery and two-cell embryo production observed under intensified gonadotropin stimulation differ from the detrimental reproductive outcomes reported under excessive hormonal stimulation in vivo. Previous studies have shown that supraphysiological ovarian stimulation may impair uterine receptivity and implantation despite increasing ovarian activity (Kalakota et al., 2022; Santos et al., 2010). This distinction highlights the difference between enhanced ovarian and early embryonic responses observed in vitro and the broader reproductive processes required for successful pregnancy establishment in vivo.
       
Nevertheless, the longer-term developmental consequences of intensified gonadotropin stimulation remain uncertain because embryonic development was evaluated only up to the two-cell stage, without assessing subsequent blastocyst development or pregnancy outcomes. Therefore, the present findings should be interpreted as reflecting early embryonic development rather than subsequent developmental competence. Further studies extending embryo culture to the blastocyst stage and evaluating implantation potential, together with molecular and cellular markers of oocyte and embryo quality, are warranted.
Progesterone priming combined with intensified gonadotropin stimulation resulted in the highest oocyte recovery and two-cell embryo production in rats. Intensified stimulation also significantly increased two-cell embryo yield in progesterone-primed females compared with standard stimulation. These findings suggest that endocrine pretreatment may influence ovarian and early embryonic responses to gonadotropin stimulation and highlight the importance of optimizing hormonal protocols for in vitro embryo production. Further studies are needed to determine whether the observed differences in early embryonic development translate into improved developmental competence and reproductive success.
The authors extend their appreciation to the Ongoing Research Funding Program (ORF-2026-811), King Saud University, Riyadh, Saudi Arabia, for funding this work. The authors also thank the staff of the Animal House Facility, Department of Zoology, King Saud University, for their technical support and assistance with animal care.
 
Funding
 
This work was supported by the Ongoing Research Funding Program (ORF-2026-811), King Saud University, Riyadh, Saudi Arabia.
 
Author contributions
 
Muath Q. Al-Ghadi conceived and designed the study and supervised the research. Shaden M. Alotaibi performed the experiments, conducted the laboratory procedures and collected the data. Shaden M. Alotaibi and Muath Q. Al-Ghadi analyzed and interpreted the data. Muath Q. Al-Ghadi provided methodological guidance. Saleh H. Alwasel contributed to study supervision and critically reviewed the manuscript. Shaden Madhi Alotaibi prepared the original draft of the manuscript. Muath Q. Al-Ghadi and Saleh H. Alwasel reviewed and revised the manuscript for important intellectual content. All authors read and approved the final version of the manuscript.
 
Data availability statement
 
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
The authors declare no competing interests.

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