title: Luteal phase support with estradiol and progesterone versus progesterone alone in GnRH antagonist ICSI cycles: a randomized controlled study.
abstract: In vitro fertilization (IVF) cycles are associated with a defective luteal phase. Although progesterone supplementation to treat this problem is standard practice, estrogen addition is debatable. Our aim was to compare pregnancy outcomes in 220 patients undergoing antagonist intracytoplasmic sperm injection (ICSI) cycles protocol. The patients were randomly assigned into two equal groups to receive either vaginal progesterone alone (90 mg once daily) starting on the day of oocyte retrieval for up to 12 weeks if pregnancy occurred or estradiol addition (2 mg twice daily) starting on the same day and continuing up to seven weeks (foetal viability scan). Primary outcomes were pregnancy and ongoing pregnancy rates per embryo transfer. Secondary outcomes were implantation and early pregnancy loss rates. Pregnancy rates showed no significant difference between group 1 (39.09%) and 2 (43.63%) (p value = 0.3). Similarly, both groups were comparable regarding ongoing pregnancy rate (32.7% group 1 and 36.3% group 2, p value = 0.1). Implantation rates showed no difference between group 1 (19.25%) and group 2 (23.44%) (p value = 0.2). Early pregnancy loss rates were comparable, with 6.3% and 7.2% in groups 1 and 2, respectively, (p value = 0.4). In conclusion, the addition of 4 mg estrogen daily to progesterone for luteal support in antagonist ICSI cycles is not beneficial for pregnancy outcome.
authors.affiliation: a Obstetrics and Gynecology Department , Ain-Shams University , Cairo , Egypt ;|b Dubai Gynecology and Fertility Centre , Dubai , UAE ;
authors.forename: Wael A
authors.initials: WA
authors.lastname: Ismail Madkour
authors.affiliation: b Dubai Gynecology and Fertility Centre , Dubai , UAE ;
authors.forename: Bassel
authors.initials: B
authors.lastname: Noah
authors.affiliation: a Obstetrics and Gynecology Department , Ain-Shams University , Cairo , Egypt ;|c IVF Unit , Enjab Hospital , Sharjah , UAE ;
authors.forename: Amr M S
authors.initials: AM
authors.lastname: Abdel Hamid
authors.affiliation: b Dubai Gynecology and Fertility Centre , Dubai , UAE ;
authors.forename: Hena
authors.initials: H
authors.lastname: Zaheer
authors.affiliation: b Dubai Gynecology and Fertility Centre , Dubai , UAE ;
authors.forename: Awatif
authors.initials: A
authors.lastname: Al-Bahr
authors.affiliation: c IVF Unit , Enjab Hospital , Sharjah , UAE ;
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Shaeer
authors.affiliation: c IVF Unit , Enjab Hospital , Sharjah , UAE ;|d Obstetrics and Gynecology Department, Al-Azhar University , Cairo , Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Moawad
mesh_terms: D000328:Adult; D004958:Estradiol / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology / Q000627:therapeutic use*; D043373:Follicle Stimulating Hormone, Human / Q000494:pharmacology / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D006080:Ovarian Follicle / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D011374:Progesterone / Q000494:pharmacology / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D006727:Hormone Antagonists; D011994:Recombinant Proteins; C571801:follitropin alfa; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; C062876:cetrorelix
keywords: GnRH antagonist; ICSI; estradiol; luteal phase support