title: Delaying the initiation of progesterone supplementation until the day of fertilization does not compromise cycle outcome in patients receiving donated oocytes: a randomized study.
abstract: OBJECTIVE
  To determine whether the initiation of P supplementation as artificial luteal phase support (day -1, day 0, or day +1 of egg donation) in extensive programs of ovum donation influences cycle cancellation, pregnancy outcome, and implantation rate in day 3 embryo transfers.
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  Oocyte donation program at the Instituto Valenciano de Infertilidad, Valencia, Spain.
  
  
  METHODS
  Three hundred recipients with normal ovarian function, absence of uterine anomalies, and undergoing their first egg donation were recruited between September 2003 and September 2004.
  
  
  METHODS
  A computer-based randomization divided the recipients into three groups when hCG was administered to their matched donors. The first group (group A) started P supplementation the day before oocyte retrieval; the second group (group B) started P supplementation on the day of the oocyte retrieval; and the third group (group C) started P supplementation 1 day after the egg retrieval once fertilization was confirmed.
  
  
  METHODS
  Implantation, pregnancy, and ongoing pregnancy rates were the primary outcome measures considered. The secondary outcome measure was the cancellation rate, especially due to fertilization failure.
  
  
  RESULTS
  Global cancellation rate and cancellation rate due to fertilization failure were significantly higher in group A (12.4% and 8.2%, respectively) than in group C (3.3% and 0%, respectively). Reproductive outcome was similar in all the groups except for a higher biochemical pregnancy rate in group A (12.9%) than in groups B (6.6%) and C (2.3%).
  
  
  CONCLUSIONS
  Initiation of P on day +1 of embryo development decreases cancellation rates of day 3 embryo transfers in extensive programs of ovum donation without any deleterious effect on pregnancy outcome or implantation rate.
authors.affiliation: Universitary Institute IVI Valencia, Valencia, Spain. mjescriba@ivi.es
authors.forename: María-José
authors.initials: MJ
authors.lastname: Escribá
authors.forename: José
authors.initials: J
authors.lastname: Bellver
authors.forename: Ernesto
authors.initials: E
authors.lastname: Bosch
authors.forename: María
authors.initials: M
authors.lastname: Sánchez
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellicer
authors.forename: José
authors.initials: J
authors.lastname: Remohí
mesh_terms: D000293:Adolescent; D000328:Adult; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000453:epidemiology* / Q000628:therapy*; D018587:Oocyte Donation / Q000379:methods / Q000706:statistics & numerical data*; D010060:Ovulation / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage*; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011374:Progesterone