Effects of estradiol supplementation during the luteal phase of in vitro fertilization cycles: a meta-analysis.
OBJECTIVE
To clarify whether adding E(2) to standard luteal P supplementation is beneficial both in GnRH agonist and antagonist IVF cycles.


METHODS
Meta-analysis of nine randomized controlled trials.


METHODS
University hospital center for reproductive medicine and IVF.


METHODS
None.


METHODS
Clinical pregnancy rate (PR) per patient, clinical PR per embryo transfer (ET), implantation rate, ongoing PR per patient, clinical abortion rate, and ectopic PR.


RESULTS
There were no statistically significant differences between E(2)+P versus P-only group regarding overall IVF outcomes. From seven studies including GnRH agonist cycles, no statistical significant differences were found between the two groups in clinical PR per patient (relative risk [RR] 1.32, 95% confidence interval [CI] 0.79-2.19), clinical PR per ET (RR 1.83, 95% CI 0.96-3.49), implantation rate (RR 1.20, 95% CI 0.34-4.21), ongoing PR per patient (RR 1.34, 95% CI 0.37-4.82), clinical abortion rate (RR 1.05, 95% CI 0.48-2.28), and ectopic PR (RR 0.53, 95% CI 0.07-4.10). Clinical PR per patient (RR 0.94, 95% CI 0.62-1.42) and ongoing PR per patient (RR 1.09, 95% CI 0.79-1.50) from three studies including GnRH antagonist cycles only were all similar between the two groups.


CONCLUSIONS
The combined data presented in this meta-analysis suggest that the addition of E(2) to P for luteal phase support does not improve IVF outcomes in GnRH agonist and antagonist cycles. However, the authors feel that there is an obvious need for further large-scale studies regarding GnRH antagonist cycles.
Jee
Byung Chul
BC
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Bundang, Seongnam, Gyeonggi 463-707, South Korea.
Suh
Chang Suk
CS
Kim
Seok Hyun
SH
Kim
Yong Beom
YB
Moon
Shin Yong
SY