title: A luteal estradiol protocol for anticipated poor-responder patients may improve delivery rates.
abstract: 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.
authors.affiliation: Blanchfield Army Community Hospital, Fort Campbell, Kentucky, USA.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
authors.forename: Grant D E
authors.initials: GD
authors.lastname: McWilliams
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Miller
authors.forename: Richard T
authors.initials: RT
authors.lastname: Scott
authors.forename: John L
authors.initials: JL
authors.lastname: Frattarelli
mesh_terms: 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
chemical_list: D005300:Fertility Agents, Female; D006062:Gonadotropins; D004958:Estradiol