A luteal estradiol protocol for expected poor-responders improves embryo number and quality.
OBJECTIVE
To compare embryo and oocyte data between a standard protocol and a luteal phase estradiol protocol.


METHODS
Retrospective paired cohort analysis.


METHODS
Private in vitro fertilization (IVF) center.


METHODS
60 poor-responder patients undergoing 120 IVF cycles.


METHODS
Addition of luteal estradiol to the standard IVF protocol.


METHODS
Number of embryos with > or = 7 cells on day 3 of development.


RESULTS
The luteal phase estradiol protocol showed a statistically significantly greater number of embryos with > or = 7 cells, oocytes retrieved, mature oocytes, and embryos than did the standard protocol. There was no difference between the two protocols with respect to basal antral follicle count, days of stimulation, number of follicles > or = 14 mm on day of surge, or endometrial thickness on day of surge. A trend toward improved pregnancy outcomes was found with the luteal estradiol protocol.


CONCLUSIONS
Giving estradiol in the luteal phase preceding IVF hyperstimulation increases the number and the quality of embryos achieved in patients deemed to have a poor response to IVF. Ultimately, this may translate into improved pregnancy outcomes in these patients.
Frattarelli
John L
JL
Reproductive Medicine Associates of New Jersey, Morristown, New Jersey. Electronic address: jfrattarelli@rmanj.com.
Hill
Micah J
MJ
Tripler Army Medical Center, Honolulu, Hawaii.
McWilliams
Grant D E
GDE
Tripler Army Medical Center, Honolulu, Hawaii.
Miller
Kathleen A
KA
Reproductive Medicine Associates of New Jersey, Morristown, New Jersey.
Bergh
Paul A
PA
Reproductive Medicine Associates of New Jersey, Morristown, New Jersey.
Scott
Richard T
RT
Reproductive Medicine Associates of New Jersey, Morristown, New Jersey.
D015331:Cohort Studies; D047108:Embryonic Development / Q000187:drug effects / Q000502:physiology; D004958:Estradiol / Q000494:pharmacology*; D004967:Estrogens / Q000494:pharmacology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects* / Q000502:physiology; D006080:Ovarian Follicle / Q000187:drug effects* / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D004967:Estrogens; D004958:Estradiol