title: Luteal estradiol supplementation in gonadotropin-releasing hormone antagonist cycles for infertile patients in vitro fertilization.
abstract: OBJECTIVE
  To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI.
  
  
  METHODS
  One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared.
  
  
  RESULTS
  Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010).
  
  
  CONCLUSIONS
  The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Su-Kyoung
authors.initials: SK
authors.lastname: Kwon
authors.forename: Chung-Hoon
authors.initials: CH
authors.lastname: Kim
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Lee
authors.forename: Il Kyung
authors.initials: IK
authors.lastname: Jeon
authors.forename: Jun-Woo
authors.initials: JW
authors.lastname: Ahn
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Hee-Dong
authors.initials: HD
authors.lastname: Chae
authors.forename: Byung-Moon
authors.initials: BM
authors.lastname: Kang
keywords: Addition of estradiol; Gonadotropin-releasing hormone antagonist; In vitro fertilization; Intracytoplasmic sperm injection; Luteal progesterone supplementation