title: Can we alter pregnancy outcome by adjusting progesterone treatment at mid-luteal phase: a randomized controlled trial.
abstract: Our study aimed to determine whether mid-luteal serum P concentrations can serve as a predictive factor for in vitro fertilization (IVF) outcomes and whether increasing P dosage for patients with low levels at mid-luteal phase may improve pregnancy rates. It was a prospective, randomized controlled study. A total of 146 patients undergoing IVF treatment were prospectively enrolled and received routine luteal phase support (LPS) regimen of Endometrin® (progesterone) 200 mg/day. Serum P levels were measured 7 days after embryo transfer (ET). Considering a cutoff level of 15 ng/ml on this day, patients with higher levels continued the same dosage until pregnancy test (control group). Patients with lower levels were randomly allocated to continue Endometrin® 200 mg/day (Group A) or to increase Endometrin® dosage to 300 mg/day (Group B). The Main Outcome Measures were pregnancy rates. Both biochemical and clinical pregnancy and live birth rates were comparable between all groups regardless of P level on day 7 of luteal phase and regardless of dose adjustment. ROC analysis determined that mid-luteal P levels of 17 ng/ml can be a better predictor of cycle outcome. In conclusion raising the P dose at mid-luteal phase to 300 mg daily did not improve cycle outcomes.
authors.affiliation: a IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Hillel Yaffe Medical Center, The Technion-Israel Institute of Technology , Hadera , Israel.
authors.forename: Nardin
authors.initials: N
authors.lastname: Aslih
authors.affiliation: a IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Hillel Yaffe Medical Center, The Technion-Israel Institute of Technology , Hadera , Israel.
authors.forename: Adrian
authors.initials: A
authors.lastname: Ellenbogen
authors.affiliation: a IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Hillel Yaffe Medical Center, The Technion-Israel Institute of Technology , Hadera , Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Shavit
authors.affiliation: a IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Hillel Yaffe Medical Center, The Technion-Israel Institute of Technology , Hadera , Israel.
authors.forename: Medeia
authors.initials: M
authors.lastname: Michaeli
authors.affiliation: a IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Hillel Yaffe Medical Center, The Technion-Israel Institute of Technology , Hadera , Israel.
authors.forename: Devora
authors.initials: D
authors.lastname: Yakobi
authors.affiliation: a IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Hillel Yaffe Medical Center, The Technion-Israel Institute of Technology , Hadera , Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Shalom-Paz
mesh_terms: D000328:Adult; D016903:Drug Monitoring; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000628:therapy*; D007248:Infertility, Male; D007557:Israel / Q000453:epidemiology; D050498:Live Birth; D008183:Luteal Phase / Q000097:blood / Q000187:drug effects*; D008297:Male; D054315:Oocyte Retrieval; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D011372:Progestins / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D012372:ROC Curve; D013488:Suppositories
chemical_list: D011372:Progestins; D013488:Suppositories; D011374:Progesterone
keywords: ART; luteal phase support; prediction of pregnancy; progesterone