title: Does progesterone supplementation improve pregnancy rates in clomiphene citrate and intrauterine insemination treatment cycles?
abstract: OBJECTIVE
  To investigate the effect of empiric use of luteal phase progesterone supplementation to improve endometrial receptivity in women undergoing treatment with clomiphene citrate in combination with intrauterine insemination (CC-IUI).
  
  
  METHODS
  Retrospective cohort analysis.
  
  
  METHODS
  University fertility center.
  
  
  METHODS
  426 CC-IUI cycles from 292 patients with unexplained infertility.
  
  
  METHODS
  Patients were treated with micronized intravaginal progesterone 100 mg twice daily beginning approximately three days after CC-IUI.
  
  
  METHODS
  Clinical pregnancy per initiated cycle as defined by presence of fetal heart rate on ultrasound.
  
  
  RESULTS
  Clinical pregnancy rate was higher in patients receiving luteal phase support compared to patients not receiving luteal phase support (odds ratio: 2.04; 95% confidence interval: 1.01-4.14) after adjusting for all factors in the analysis using a multivariate logistic regression model. Age at the start of the cycle, BMI and CC dose were not shown to have an effect on clinical pregnancy rates. Patients with endometrial lining (EML) thickness 6-8 mm and >8 mm had increased clinical pregnancy rates compared to EML <6 mm independent of luteal phase progesterone use. Patients who appear to receive the greatest benefit of progesterone supplementation are in the 6-8 mm EML cohort.
  
  
  CONCLUSIONS
  Luteal phase progesterone supplementation in CC-IUI cycles can improve endometrial receptivity as judged by the improved clinical pregnancy rates as the primary outcome.
authors.affiliation: Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, University Hospitals Case Medical Center , Cleveland, OH , USA and.
authors.forename: Sonia
authors.initials: S
authors.lastname: Elguero
authors.forename: Allison
authors.initials: A
authors.lastname: Wyman
authors.forename: William W
authors.initials: WW
authors.lastname: Hurd
authors.forename: Nichole
authors.initials: N
authors.lastname: Barker
authors.forename: Bansari
authors.initials: B
authors.lastname: Patel
authors.forename: James H
authors.initials: JH
authors.lastname: Liu
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007315:Insemination, Artificial; D008183:Luteal Phase / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D011374:Progesterone
keywords: Clomiphene citrate; IUI; endometrial receptivity; luteal phase progesterone; unexplained infertility