Clin Exp Reprod Med.  2013 Sep;40(3):131-134. 10.5653/cerm.2013.40.3.131.

Luteal estradiol supplementation in gonadotropin-releasing hormone antagonist cycles for infertile patients in vitro fertilization

• Kwon SK
• Kim CH
• Lee KH
• Jeon IK
• Ahn JW
• Kim SH
• Chae HD
• Kang BM

• KMID: 2167504
• DOI: http://doi.org/10.5653/cerm.2013.40.3.131

Abstract

OBJECTIVE
To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI.
METHODS
One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared.
RESULTS
Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010).
CONCLUSION
The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.

Keyword

Luteal progesterone supplementation; Gonadotropin-releasing hormone antagonist; Addition of estradiol; In vitro fertilization; Intracytoplasmic sperm injection

MeSH Terms

Aged
Embryo Implantation
Estradiol
Female
Fertilization in Vitro
Follicle Stimulating Hormone, Human
Gonadotropin-Releasing Hormone
Humans
Incidence
Ovulation Induction
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Progesterone
Prospective Studies
Sperm Injections, Intracytoplasmic
Uterine Hemorrhage
Estradiol
Follicle Stimulating Hormone, Human
Gonadotropin-Releasing Hormone
Progesterone