Document Detail


Addition of estradiol to progesterone for luteal supplementation in patients stimulated with GnRH antagonist/rFSH for IVF: a randomized controlled trial.
MedLine Citation:
PMID:  16857887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The role of progesterone for luteal support in stimulated cycles for IVF is well established. However, controversy still surrounds the benefit of additional supplementation with estradiol (E2) in GnRH agonist (GnRHa) cycles, while no such data are available for GnRH antagonists. The aim of this randomized controlled trial (RCT) was to compare ongoing pregnancy rates in patients stimulated with recombinant FSH (rFSH) and GnRH antagonist for IVF, who received micronized progesterone for luteal phase supplementation, with or without the addition of E2. METHODS: Two hundred and one patients underwent ovarian stimulation with a fixed dose of 200 IU rFSH and GnRH antagonist. Patients were randomized to receive, for luteal phase supplementation, either 600 mg of micronized progesterone vaginally (n=100, progesterone group) or 600 mg of micronized progesterone and 4 mg of E2 valerate orally (n=101, progesterone/E2 group). The main outcome measure was ongoing pregnancy at 12 weeks per patient randomized. RESULTS: Demographics, stimulation parameters and embryological data were comparable for the two groups compared. Twenty-six ongoing pregnancies were achieved in the progesterone (26%) and 30 in the progesterone/E2 group (29.7%). (Difference: 3.7 and 95%, CI: -15.8 to 8.6%). CONCLUSION: It appears that the addition of E2 to progesterone in the luteal phase after stimulation with rFSH and GnRH antagonist does not enhance the probability of pregnancy.
Authors:
H M Fatemi; E M Kolibianakis; M Camus; H Tournaye; P Donoso; E Papanikolaou; P Devroey
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-07-20
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  21     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-25     Completed Date:  2006-11-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  2628-32     Citation Subset:  IM    
Affiliation:
Centre for Reproductive Medicine, Dutch-Speaking Free University Brussels, Laarbeeklaan, Brussels, Belgium. hmousavi@az.vub.ac.be
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MeSH Terms
Descriptor/Qualifier:
Chorionic Gonadotropin / therapeutic use
Corpus Luteum / drug effects,  physiology*
Drug Therapy, Combination
Embryo Transfer
Estradiol / analogs & derivatives*,  therapeutic use
Estrogens, Conjugated (USP) / therapeutic use
Female
Fertilization in Vitro / methods*
Follicle Stimulating Hormone / therapeutic use*
Gonadotropin-Releasing Hormone / antagonists & inhibitors*
Humans
Ovulation Induction / methods*
Polycystic Ovary Syndrome
Pregnancy
Pregnancy Outcome
Progesterone / therapeutic use*
Recombinant Proteins / therapeutic use
Sperm Injections, Intracytoplasmic
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Estrogens, Conjugated (USP); 0/Recombinant Proteins; 33515-09-2/Gonadotropin-Releasing Hormone; 50-28-2/Estradiol; 57-83-0/Progesterone; 9002-68-0/Follicle Stimulating Hormone; 979-32-8/estradiol valerate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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