A luteal estradiol protocol for anticipated poor-responder patients may improve delivery rates.
OBJECTIVE
To compare IVF data and outcomes between a standard protocol and a luteal phase E(2) protocol.


METHODS
Retrospective cohort analysis.


METHODS
Large academic assisted reproduction technologies center.


METHODS
Fifty-seven infertile patients with a history of poor response to IVF stimulation and 228 matched control patients.


METHODS
IVF with a standard protocol or a luteal phase E(2) protocol.


METHODS
Live-birth rates.


RESULTS
Patients in the luteal E(2) protocol required more days of stimulation and total gonadotropins and had higher peak E(2) levels when compared with the control group. The luteal E(2) protocol showed a greater percentage of embryos with >or=7 cells on day 3. A trend toward improved delivery rates was seen in the luteal E(2) protocol (28.1% vs. 22.4%; relative risk, 1.25, 0.78-2.03).


CONCLUSIONS
A luteal E(2) protocol results in improved day 3 embryo development as demonstrated by the percent of embryos at the >or=7-cell stage. Likewise, the luteal E(2) protocol may ultimately improve pregnancy outcomes for patients with poor response to IVF stimulation.
Hill
Micah J
MJ
Blanchfield Army Community Hospital, Fort Campbell, Kentucky, USA.
McWilliams
Grant D E
GD
Miller
Kathleen A
KA
Scott
Richard T
RT
Frattarelli
John L
JL
D000328:Adult; D015331:Cohort Studies; D004334:Drug Administration Schedule; D046149:Embryo Culture Techniques; D004624:Embryo Transfer; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D006062:Gonadotropins / Q000008:administration & dosage*; D006801:Humans; D050498:Live Birth; D008183:Luteal Phase / Q000187:drug effects*; D054315:Oocyte Retrieval; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D006062:Gonadotropins; D004958:Estradiol