Estradiol supplementation during the luteal phase may improve the pregnancy rate in patients undergoing in vitro fertilization-embryo transfer cycles.
OBJECTIVE
To evaluate the effect of adding E(2) to progestin supplementation during the luteal phase on pregnancy and implantation rates in patients undergoing IVF cycles.


METHODS
Prospective, randomized study.


METHODS
An IVF unit in a university hospital.


METHODS
Patients who were undergoing IVF with controlled ovarian hyperstimulation using a GnRH analog and who had E(2)2,500 pg/dL at the time of hCG administration.


METHODS
Serum concentrations of E(2) and progesterone were measured in all patients on days 7, 10, and 12 after ET.


METHODS
The E(2) and progesterone profiles of the luteal phase and the pregnancy and implantation rates were documented. Data were analyzed for the entire study population and further stratified according to the GnRH analog protocol used (short or long).


RESULTS
Significantly higher E(2) levels were found during the luteal phase in the group that received E(2) supplementation. This effect was more pronounced in the patients who were treated with the long GnRH analog protocol. Significantly higher pregnancy and implantation rates were recorded in the patients who received E(2) supplementation and were treated with the long GnRH analog protocol.


CONCLUSIONS
For patients who are treated with the long GnRH analog protocol for controlled ovarian hyperstimulation and for whom luteal support with hCG is contraindicated, the addition of E(2) to the progestin support regimen may have a beneficial effect on pregnancy and implantation rates.
Farhi
J
J
In Vitro Fertilization Unit, Wolfson Medical Center, Holon, Israel.
Weissman
A
A
Steinfeld
Z
Z
Shorer
M
M
Nahum
H
H
Levran
D
D
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D015536:Down-Regulation; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods* / Q000706:statistics & numerical data; D004958:Estradiol / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000706:statistics & numerical data; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood / Q000627:therapeutic use; D011446:Prospective Studies
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol