Does luteal estradiol supplementation have a role in long agonist cycles?
OBJECTIVE
To test the hypothesis that the addition of 6 mg estradiol (E2) valerate either orally or vaginally to progesterone (P) for luteal support, can increase the probability of pregnancy in intracytoplasmic sperm injection (ICSI) cycles using the long agonist protocol.


METHODS
Prospective open-labeled randomized controlled trial.


METHODS
Private and university fertility centers.


METHODS
Women undergoing ICSI cycles, with controlled ovarian hyperstimulation using long agonist protocol.


METHODS
On embryo transfer day, participants were randomized to receive, only P (group A, n = 90), P along with 6 mg E(2) valerate either orally (group B, n = 90), or vaginally (group C, n = 90) for luteal support.


METHODS
Clinical pregnancy was the main outcome. luteal serum E(2) and P profiles were the secondary outcomes.


RESULTS
Highest pregnancy rate was achieved in group C (45.56%), it was significantly higher than A (relative risk 1.52, 95% CI: 1.03 to 2.24). Day 0 (hCG day) E2 levels were similar in the three groups. Group A had lower E2 levels on days 7, 10, and 13 and a higher magnitude of E2 decline on days 7 and 10. Similar levels of luteal E2 were documented in groups B and C. P levels were similar in the three groups.


CONCLUSIONS
Addition of 6 mg E(2) valerate to P support may encumber the sharp decline in luteal E(2) level. It may enhance the probability of pregnancy if administered vaginally.
Elgindy
Eman A
EA
AlBanoon Fertility Center, Department of Obstetrics & Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
El-Haieg
Dahlia O
DO
Mostafa
Magdy I
MI
Shafiek
Mostafa
M
D000328:Adult; D000465:Algorithms; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000628:therapy*; D008183:Luteal Phase / Q000097:blood / Q000187:drug effects* / Q000502:physiology; D008991:Monitoring, Physiologic / Q000379:methods; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage; D020554:Sperm Injections, Intracytoplasmic; D055815:Young Adult
D004338:Drug Combinations; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol