Progesterone-to-Oocyte Ratio Study Retracted After Editors Question ROC Curve Similarity

The Editors in Chief of the Journal of Ovarian Research have retracted a 2021 study that examined whether serum progesterone levels on the day of human chorionic gonadotrophin administration and the ratio of that progesterone level to metaphase II oocyte count could predict IVF/ICSI outcomes in patients with normal ovarian reserve. The retraction notice states that concerns were raised about the similarity between the ROC curves for the progesterone-to-estradiol ratio and for serum progesterone in Figures 2 and 3 of the original publication. When the authors were asked to provide their raw data, they did not respond. The editors concluded that they had lost confidence in the integrity of the results reported in the article.

The original study, published on 01 April 2021, investigated a question that many fertility researchers find compelling: whether routine blood markers measured during ovarian stimulation could serve as early predictors of success in assisted reproduction. Specifically, the authors looked at serum progesterone levels on the day of hCG administration and the ratio of that progesterone level to the number of metaphase II oocytes retrieved. The idea was that these values might help clinicians anticipate IVF/ICSI outcomes before embryo transfer, potentially guiding decisions about cycle management in patients with normal ovarian reserve.

The retraction notice notes that the authors did not explicitly state whether they agreed to the retraction. The notice does not elaborate on the nature of the concerns beyond the similarity between the ROC curves for the progesterone-to-estradiol ratio and for serum progesterone in the two figures. The editors’ decision reflects a standard but serious response in research publishing: when raw data cannot be produced to address questions about figure integrity, confidence in the published results cannot be maintained.

ROC curves, or receiver operating characteristic curves, are a widely used analytical tool in clinical prediction studies. They plot the true positive rate against the false positive rate at various threshold settings, allowing researchers to evaluate how well a biomarker discriminates between patients who will and will not experience a particular outcome. In fertility research, ROC curves are often used to identify cutoff values for hormones like progesterone that might predict clinical pregnancy, live birth, or oocyte quality. When two ROC curves in the same study appear suspiciously similar, particularly when they are supposed to represent different biomarkers, it raises questions about whether the underlying data were processed independently.

The progesterone-to-oocyte ratio concept that the original study explored is part of a broader effort in reproductive medicine to find accessible, low-cost predictors of IVF/ICSI success. Serum progesterone is routinely measured during ovarian stimulation protocols, and elevated progesterone on the day of hCG administration has been associated in some studies with reduced endometrial receptivity and poorer outcomes. The ratio of progesterone to the number of metaphase II oocytes was proposed as a way to account for both the hormonal environment and the ovarian response simultaneously, potentially offering a more nuanced predictor than either value alone.

The retraction notice does not detail the specific statistical concerns or the extent of the similarity between the figures. However, the editors’ decision to retract without author agreement underscores the seriousness with which journals treat questions about data integrity when authors are unable or unwilling to provide raw data for verification. In such cases, the burden of proof rests with the authors to demonstrate that the published results are sound.

This retraction is part of a growing pattern in scientific publishing where journals are increasingly vigilant about figure integrity, data availability, and author responsiveness. The Committee on Publication Ethics, which provides guidance to journals on handling misconduct concerns, recommends that editors seek explanations from authors and request raw data when concerns arise. When authors do not respond or cannot provide adequate documentation, retraction is often the appropriate outcome to protect the scientific record.

For clinicians and researchers who may have cited the original study, the retraction means that the findings should no longer be relied upon as evidence for the predictive value of serum progesterone levels or progesterone-to-oocyte ratios in IVF/ICSI outcomes. The retraction notice is now linked to the original article, ensuring that readers who encounter the study will be aware of its retracted status. The original article remains online but is marked as retracted, following standard practice in open access publishing.

The case highlights the ongoing challenges in maintaining research integrity in fertility and reproductive medicine, where the pressure to publish novel findings about biomarkers and predictors of assisted reproduction success remains high. As analytical tools become more sophisticated and journals adopt more rigorous checks on figure authenticity and data provenance, questions about the reliability of published results are increasingly being raised before they can influence clinical practice. The editors’ decision in this case reflects the importance of raw data availability as a cornerstone of scientific verification.

Subject of Research: Retraction Note: The value of serum progesterone level on day of human chorionic gonadotrophin administration/metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve

Article Title: Retraction Note: The value of serum progesterone level on day of human chorionic gonadotrophin administration/metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve

Article References: Mahran, A., Khairy, M., Elkhateeb, R., Hegazy, A. R., Abdelmeged, A., El-Saber Batiha, G., Alsharif, K. F., Hetta, H. F., & Bahaa, H. A. (2026). Retraction Note: The value of serum progesterone level on day of human chorionic gonadotrophin administration/metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve. Journal of Ovarian Research, 19(1), Article 316. https://doi.org/10.1186/s13048-026-02302-8

Image Credits: AI Generated

DOI: 10.1186/s13048-026-02302-8

Keywords: Retraction, Journal of Ovarian Research, IVF, ICSI, Progesterone, ROC curves, Research integrity, Fertility research, Note, value, serum, level