The impact of luteal supplement on pregnancy outcome following stimulated IVF cycles.
This is a prospeve randomised study designed to clarify the impact of various luteal support regimes (HCG and progesterone) on progesterone profiles and pregnancy outcomes. This study involved subjects undergone down regulated. stimulated IVF cycles using various types of luteal support, namely: Cyclogest (n=35). Crinone gel (n=36), various doses of Utrogestan (n=55) and HCG (n=35). Various doses of Utrogestan (administered vaginally), Crinone gel (progesterone administered vaginally) and Cyclogest (progesterone administered rectally) supplementation induced similar end plasma progesterone concentrations ranging from 26 to 32 mmnl/l. These progesterone regimes produced no significant differences. Hence, the impact of exogenous proge,terone supplement was relatively trivial and did not 'stabilise' the sub-optimal luteal phase. In contrast, two small HCG injections during the early and mid-luteal phase possessed a much greater ability to 'stabilise' progesterone profiles. Despite this additional advantage, implantation and pregnancy rates with either HCG or progesterone supplements were similar. Although none of these forms of luteal support adequately 'normalised' luteal progesterone profiles, this did not appear to be detrimental to the process of implantation.
Tay
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Department of Obstetrics and Gynaecology, University Malaya Medical Centre, Kuala Lumpur.
Lenton
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EA
D000282:Administration, Intravaginal; D000285:Administration, Rectal; D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D005782:Gels; D011374:Progesterone