Delaying the initiation of progesterone supplementation until the day of fertilization does not compromise cycle outcome in patients receiving donated oocytes: a randomized study.
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.
Escribá
María-José
MJ
Universitary Institute IVI Valencia, Valencia, Spain. mjescriba@ivi.es
Bellver
José
J
Bosch
Ernesto
E
Sánchez
María
M
Pellicer
Antonio
A
Remohí
José
J
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
D011374:Progesterone