Estradiol supplementation during the luteal phase of IVF-ICSI patients: a randomized, controlled trial.
OBJECTIVE
To evaluate the effectiveness of transdermal E(2) administration in the luteal phase of IVF/ICSI cycles.


METHODS
Prospective, open-label, randomized clinical trial.


METHODS
University-affiliated assisted reproduction center.


METHODS
1) Pilot trial to test serum E(2) behaviour during the luteal phase in women undergoing agonist as well as antagonist protocol; 2) women undergoing IVF/ICSI with good-quality embryos available.


METHODS
One hundred seventy-six patients were randomized by random number list on the day of embryo transfer to either: 1) progesterone (P) only as luteal support (200 mg bid starting the following night after oocyte retrieval); or 2) E(2) and P combined, applying E(2) patches (100 microg/day) twice per week beginning on the day of embryo transfer with P, as in the P-only group.


METHODS
The primary outcome was implantation rate per embryo transfer; secondary outcome variables were pregnancy rate per embryo transfer, early pregnancy loss, multiple pregnancy rate, and midluteal P and E(2) levels.


RESULTS
Hormonal levels did not differ between groups. There were no statistically significant differences in terms of implantation rate (34.9% [51 of 146] vs. 28.9% [41 of 142]), ongoing pregnancy rate 42% ([34 of 81] vs. 41.8% [33 of 79]), early pregnancy loss (15% [6 of 40] vs. 13.2% [5 of 38]), or multiple pregnancy rate (28.6% [12 of 42] vs. 24.4% [10/41]) in patients receiving P versus E(2) + P.


CONCLUSIONS
The addition of transdermal E(2) to the luteal-phase P support of IVF cycles did not improve cycle outcomes in terms of implantation and pregnancy rates.
Serna
José
J
IVI-Madrid, Madrid, Spain.
Cholquevilque
José L
JL
Cela
Vito
V
Martínez-Salazar
Javier
J
Requena
Antonio
A
Garcia-Velasco
Juan A
JA
D000279:Administration, Cutaneous; D000282:Administration, Intravaginal; D000328:Adult; D004359:Drug Therapy, Combination; D010064:Embryo Implantation / Q000187:drug effects; D004624:Embryo Transfer; D004958:Estradiol / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000097:blood; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000503:physiopathology / Q000628:therapy*; D008183:Luteal Phase / Q000187:drug effects*; D054315:Oocyte Retrieval; D010062:Ovulation Induction; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage* / Q000097:blood; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome; D055815:Young Adult
D005300:Fertility Agents, Female; D011374:Progesterone; D004958:Estradiol