Human chorionic gonadotropin and intravaginal natural progesterone are equally effective for luteal phase support in IVF

Abstract

This prospective randomized study compared human chorionic gonadotropin (hCG) and micronized transvaginal progesterone for luteal support in 310 in vitro fertilization (IVF) patients treated with leuprolide acetate and gonadotropins in a long protocol, and showing normal ovarian response. Both treatment groups were homogeneous for age, BMI, stimulation treatment and ovarian response. Pregnancy rates per embryo transfer were not significantly different (33.1% for the hCG group versus 38.7% for the progesterone group). For IVF patients with a normal response to stimulation under pituitary suppression, the use of hCG or progesterone for luteal support does not seem to have any effect on pregnancy rate. The choice of luteal treatment must balance medical hazard and patient convenience, as both therapeutic regimens seem equally effective.

Oral dydrogesterone versus intravaginal micronised progesterone as luteal phase support in assisted reproductive technology (ART) cycles: Results of a randomised study

“…The role of vaginal micronised progesterone as an effective agent for luteal support has been well established in international studies [9][10][11][12], and it is therefore used routinely in the majority of ART centers. Dydrogesterone, a retroprogesterone, is another type of progestogen that can be used for luteal phase support in IVF-embryo transfer programmes [13][14][15].…”

Luteal supplementation in in vitro fertilization: more questions than answers

“…Several studies have compared vaginal P 4 and hCG. The clinical pregnancy rates were similar in both categories (34,51,52). Similarly, there was no difference in the clinical pregnancy rates in studies comparing the IM route of P 4 to hCG (34,(48)(49)(50).…”

“…However, the live birth rates were not statistically different (49). Several randomized trials did not show a difference between hCG and P 4 in terms of ongoing pregnancy rates per embryo transfer (50)(51)(52). Several studies have compared vaginal P 4 and hCG.…”

Η Συμβολή Της Εργαστηριακής Διερεύνησης Βιοχημικών Παραμέτρων Στην Επιτυχία Της Εξωσωματικής Γονιμοποίησης

“…Η ορμονική υποστήριξη της ωχρινικής φάσης στις γυναίκες που υποβάλλονται σε προγράμματα I.V.F με ωοθηκική διέγερση φαίνεται ότι είναι απαραίτητη και πρωτίστης σημασίας Fauser, 2000, Pritts andAtwwod, 2002). Τα ορμονικά σκευάσματα, που έχουν χρησιμοποιηθεί, περιλαμβάνουν κυρίως την προγεστερόνη σε ενδομυϊκή ή σε ενδοκολπική χορήγηση και την ανθρώπινη χοριακή γοναδοτροπίνη (hCG) (Abate et al, 1999, Martinez et al, 2000, Ludwig et al, 2001, Daya and Cunby, 2004. Τα τελευταία χρόνια αναφέρεται από κάποιους και μια ενδεχόμενη ευεργετική επίδραση και στην υποστήριξη της ωχρινικής φάσης των GnRH αγωνιστών, που αν χορηγηθούν κατάλληλα φαίνεται ότι βελτιώνονται τα ποσοστά επιτυχούς εμφύτευσης και τελικά επίτευξης κύησης (Tesarik et al, 2006, Pirard et al, 2006.…”