Comparison of Pregnancy Outcomes of Progesterone or Progesterone + Estradiol for Luteal Phase Support in ICSI-ET Cycles

Abstract

Objective: To find out the effect of estradiol with progesterone for luteal phase support in IVF-ICSI cycles. Materials and Methods: Patients were accepted for treatment in the ART unit of Selcuk University, Meram Faculty of Medicine, between January 2001 and March 2003. The study was done in a prospective manner. The age range of 252 women was 19–41 years and the total number of cycles was 310. All patients were treated with a long ovulation induction protocol. Patients were treated and divided into two groups in a randomized manner: group I used only 600 mg/day divided into three equal doses of micronized progesterone vaginally, and group II used transdermal estradiol 100 µg/day + 600 mg/day vaginal micronized progesterone. Results: 310 ICSI cycles were carried out in 252 infertile couples between January 2001 and March 2003. From 22 of these cycles, oocytes were retrieved but no embryos were developed. In the remaining 288 cycles there were embryo transfers. All embryo development was achieved by ICSI treatment. In 148 out of 288 cycles, the luteal phase was supported only by vaginal micronized progesterone (group I). On the other hand, the remaining 140 cycles received vaginal micronized progesterone plus transdermal estradiol 100 µg/day (group II). The number of β-hCG-positive results in group I and group II were 20 (13.5 %) and 54 (38.5%) respectively. Conclusion: Adding estradiol to progesterone for luteal phase support in ICSI-ET cycles may increase implantation and pregnancy rates.

The effect of luteal phase vaginal estradiol supplementation on the success of in vitro fertilization treatment: a prospective randomized study

“…However, multiple cycles of IVF treatment from the same patients were included in the study without adjusting for the clustering of multiple cycles within the same subject. It is interesting to note that other randomized studies that have found significant improvement in pregnancy rates after E 2 supplementation have included multiple cycles from the same patient without the appropriate statistical adjustments (4)(5)(6)(7). In this current study, we included only one cycle of treatment from each patient to exclude the bias of the correlation between multiple cycles.…”

Matched-samples comparison of intramuscular versus vaginal progesterone for luteal phase support after in vitro fertilization and embryo transfer

“…The use of hCG also doubled the risk of ovarian hyperstimulation syndrome (OHSS) compared with the use of progesterone (7). Other RCTs have shown that the addition of estrogen to progesterone in the luteal phase following a long GnRHa protocol further improves implantation rates (9,10).…”

A comparison of the effects of three different luteal phase support protocols on in vitro fertilization outcomes: a randomized clinical trial

“…The exclusion criteria were the following: [1] an hCG day E 2 level above 3,000 pg/mL (because of ovarian hyperstimulation syndrome [OHSS] risk), [2] diminished ovarian reserve (FSH >12 IU/mL), [3] endometriosis greater than stage II, [4] severe male factor (<5 million motile spermatozoa per milliliter requiring testicular sperm extraction, [5] endocrine disorders, [6] polycystic ovary syndrome, or [7] frozen-thawed cycles.…”