A prospective randomized study on oestradiol valerate supplementation in addition to intravaginal micronized progesterone in buserelin and HMG induced superovulation.
A prospective randomized study was conducted to evaluate the use of adding oestradiol valerate 6 mg per os daily to intravaginal micronized progesterone (600 mg daily) as luteal supplements. The study comprised 378 infertile women superovulated with a gonadotrophin releasing-hormone agonist (GnRHa) and human menopausal gonadotrophins (HMG) for in-vitro fertilization (IVF) or zygote intra-Fallopian transfer (ZIFT). The clinical pregnancy rate was similar (29%) whether or not oestradiol valerate was added to intravaginal progesterone. Eighteen out of twenty-two endometrial biopsies were in phase, and morphological evaluations of the two luteal supplementation groups were not different. Serum hormone profiles in singleton pregnancies showed a similar day of appearance of human chorionic gonadotrophin (HCG) in both protocols but significantly lower oestradiol concentrations arose in the group without oestradiol valerate. In 32% of the singleton pregnancies, the first appearance of HCG occurred later than day 12 after HCG injection; in those ongoing pregnancies, corpus luteum rescue--as measured by significantly lower serum oestradiol and progesterone concentrations--was compromised. This study provided no evidence of any benefit of routinely supplementing GnRHa/HMG cycles with oestradiol valerate in addition to intravaginal micronized progesterone.
Smitz
J
J
Centre for Reproductive Medicine, Akademisch Ziekenhuis, Brussels, Belgium.
Bourgain
C
C
Van Waesberghe
L
L
Camus
M
M
Devroey
P
P
Van Steirteghem
A C
AC
D000282:Administration, Intravaginal; D001706:Biopsy; D002064:Buserelin / Q000627:therapeutic use*; D002985:Clinical Protocols; D004958:Estradiol / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008183:Luteal Phase / Q000097:blood; D008596:Menotropins / Q000097:blood / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011374:Progesterone / Q000008:administration & dosage* / Q000097:blood; D011446:Prospective Studies; D013480:Superovulation
D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D002064:Buserelin