Does pre-treatment with micronized progesterone affect the ovarian response to a gonadotropin releasing hormone agonist flare-up protocol?
The purpose of this study was to investigate the ovarian response and the receptivity of the endometrium in women pre-treated with micronized progesterone. Eighty-two normogonodotropic women undergoing in vitro fertilization were studied. Thirty received micronized progesterone 1500 mg/day from day 21 of the cycle for a minimum of 2 weeks, and 52 did not receive micronized progesterone (control group). A gonadotropin releasing hormone agonist (GnRH-a) was administered to all the patients in the follicular phase (flare-up). Twenty-five cycles were cancelled for fertilization failure due to male factor, 12 (40%) in the progesterone group and 13 (25%) in the control group (p = 0.271). There was no difference in the number of oocytes retrieved (7.3 +/- 5 vs. 8.2 +/- 4), fertilization rate (50.8% vs. 65%), clinical pregnancy rate (16.6% vs. 25%) or implantation rate (8% vs. 14%). In the progesterone group cases without fertilization, we performed two biopsies to evaluate the receptivity of the endometrium. Pinopode expression was noted 7 days after oocyte retrieval. It seems that the administration of micronized progesterone in the previous cycle does not affect the ovarian response to the combination of follicular phase GnRH-a and gonadotropins, nor the receptivity of the endometrium.
IVF Unit, Alexandra Maternity Hospital, First Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece.
D
D
Loutradis
K
K
Stefanidis
P
P
Drakakis
K
K
Kallianidis
A
A
El Sheikh
S
S
Milingos
K
K
Siskos
S
S
Michalas
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002064:Buserelin / Q000008:administration & dosage; D002452:Cell Count; D004717:Endometrium / Q000502:physiology / Q000648:ultrastructure; D005260:Female; D005307:Fertilization in Vitro; D005498:Follicular Phase; D006801:Humans; D008855:Microscopy, Electron, Scanning; D009865:Oocytes; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage*; D020858:Tissue and Organ Harvesting; D017211:Treatment Failure
D011374:Progesterone; D002064:Buserelin