Luteal support with intravaginal progesterone increases clinical pregnancy rates in women with polycystic ovary syndrome using letrozole for ovulation induction.
OBJECTIVE
To determine the effect of intravaginal micronized P on pregnancy rates in clomiphene citrate and letrozole ovulation induction cycles in women with polycystic ovary syndrome (PCOS).


METHODS
Retrospective chart review.


METHODS
University-based assisted reproductive technology program.


METHODS
Women with PCOS who underwent ovulation induction with either clomiphene citrate (n = 90) or letrozole (n = 31) from January 2002 to December 2008.


METHODS
Clomiphene citrate (50-250 mg x 5 days) or letrozole (5 mg x 5 days) were used for ovulation induction. After either intercourse or IUI, patients received intravaginal micronized P (200 mg twice daily) according to prescribing physician preference.


METHODS
Clinical pregnancy rate.


RESULTS
In clomiphene cycles, clinical pregnancies were documented in 15.3% of cycles (19 of 124) in the P group, compared with 12.1% (11 of 91) of the non-P group. In letrozole cycles, clinical pregnancies were documented in 21.1% of cycles (8 of 38) in the P group, compared with none (0 of 13) in the non-P group.


CONCLUSIONS
Women with PCOS who used letrozole for ovulation induction had higher clinical pregnancy rates when using intravaginal P support. Luteal supplementation with P should be strongly considered in women with PCOS, especially in those using letrozole for ovulation induction.
Montville
Christopher P
CP
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH 45219, USA.
Khabbaz
Maram
M
Aubuchon
Mira
M
Williams
Daniel B
DB
Thomas
Michael A
MA
D000282:Administration, Intravaginal; D000328:Adult; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D002996:Clomiphene / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000188:drug therapy*; D007315:Insemination, Artificial; D000077289:Letrozole; D008183:Luteal Phase / Q000187:drug effects; D009570:Nitriles / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage*; D011372:Progestins / Q000008:administration & dosage; D012189:Retrospective Studies; D014230:Triazoles / Q000008:administration & dosage*; D055815:Young Adult
D047072:Aromatase Inhibitors; D009570:Nitriles; D011372:Progestins; D014230:Triazoles; D002996:Clomiphene; D011374:Progesterone; D000077289:Letrozole