Prospective randomized study comparing luteal phase support for ICSI patients up to the first ultrasound compared with an additional three weeks.
BACKGROUND
There is a consensus that administration of progesterone to women after IVF for luteal phase support (LPS) is associated with a higher ongoing pregnancy rate. However there are few studies, including only one randomized study, which have examined the optimal duration of LPS.


METHODS
A questionnaire concerning details of LPS was returned from 21 leading IVF centres. We then randomized 257 women, who were pregnant after ICSI on day of first ultrasound, into two groups: to continue LPS for three more weeks or to stop on the day of ultrasound.


RESULTS
The duration of LPS in the questionnaire varied from the day of positive pregnancy test up to 12 weeks of pregnancy in different centres. In the randomized study, 132 patients in Group A continued LPS for 3 weeks after first ultrasound, whereas 125 patients in Group B stopped LPS on day of first ultrasound. After confirming pulsations, the miscarriage rate up to 20 weeks of gestation was 4.6% (6/132) in group A and 4.8% (6/125) in group B [odds ratios (OR) = 0.94; 95% confidence intervals (CI) = 0.3-3.1]. Bleeding episodes were 15.9% in Group A compared with 20.8% in group B (OR = 0.72; 95% CI = 0.38-1.36).


CONCLUSIONS
There is no international consensus about the duration of LPS; our single-centre randomized trial did not support extending the LPS beyond the day of first ultrasound demonstrating echoes and pulsations. Trials registry number-ISRCTN: 88722916.
Aboulghar
Mohamed A
MA
The Egyptian IVF-ET Centre, 3 St. 161 Hadaek El-Maadi, Maadi, Cairo 11431, Egypt. ghar@link.net
Amin
Yahia M
YM
Al-Inany
Hesham G
HG
Aboulghar
Mona M
MM
Mourad
Latouna M
LM
Serour
Gamal I
GI
Mansour
Ragaa T
RT
D000328:Adult; D005260:Female; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage*; D020554:Sperm Injections, Intracytoplasmic / Q000187:drug effects* / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors
D011374:Progesterone