title: Human chorionic gonadotropin combined with progesterone for luteal support improves pregnancy rate in patients with low late-midluteal estradiol levels in IVF cycles.
abstract: OBJECTIVE
  To investigate how late-midluteal estradiol levels relate to the pregnancy outcome in IVF cycles, and to assess whether human chorionic gonadotropin (hCG) for luteal support benefits the pregnancy outcome of patients with low late-midluteal estradiol levels.
  
  
  METHODS
  The pregnancy rate of 436 women undergoing first IVF cycles with long protocol and luteal support with progesterone alone were analyzed. Unsuccessful women with low late-midluteal estradiol levels (< 100 pg/mL) proceeded with the exploratory second IVF cycles where they were randomly given with either progesterone alone (P protocol) or hCG +progesterone (P+hCG protocol) for luteal support.
  
  
  RESULTS
  Pregnancy rate in women with low late-midluteal estradiol levels was significantly lower compared to that with medium (100-500 pg/mL) and high (> 500 pg/mL) levels (13.3, 26.8, and 36.3%, respectively). P+hCG protocol increased late-midluteal estradiol levels and produced a significantly higher pregnancy rate (31.7%) than P protocol (13.7%).
  
  
  CONCLUSIONS
  hCG in combination with progesterone for luteal support was suggested to benefit women undergoing IVF with low late-midluteal estradiol levels.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Fujimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osuga
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yano
authors.forename: Osamu
authors.initials: O
authors.lastname: Tsutsumi
authors.forename: Mikio
authors.initials: M
authors.lastname: Momoeda
authors.forename: Koji
authors.initials: K
authors.lastname: Kugu
authors.forename: Kaori
authors.initials: K
authors.lastname: Koga
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Morita
authors.forename: Osamu
authors.initials: O
authors.lastname: Wada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Taketani
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D003340:Corpus Luteum Maintenance / Q000187:drug effects* / Q000502:physiology; D004359:Drug Therapy, Combination; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008183:Luteal Phase / Q000097:blood / Q000187:drug effects / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D006063:Chorionic Gonadotropin; D011374:Progesterone; D004958:Estradiol