Optimization of estradiol supplementation during the luteal phase improves the pregnancy rate in women undergoing in vitro fertilization-embryo transfer cycles

Abstract

Objective: To evaluate the influence of different E2 supplementation doses during the luteal phase on implantation and pregnancy rates in women undergoing intracytoplasmic sperm injection (ICSI) cycles.

Design: Prospective, randomized study.

Setting: A private IVF unit.

Patient(s): One hundred sixty-six women younger than 40 years who were undergoing IVF with long protocol controlled ovarian hyperstimulation (COH). A total of 231 cycles were investigated. Group 1 (P only) included 80 cycles, group 2 (P and 2 mg of E2) included 73 cycles, and group 3 (P and 6 mg of E2) included 78 cycles.

Intervention(s): Supplementation in the luteal phase with different doses of E2 (0, 2, or 6 mg/d).

Main outcome measure(s): Serum E2 and P levels in the late luteal phase, and implantation rate and pregnancy rate (PR) were documented. The data were analyzed with regard to the entire study population and further stratified according to the E2 dose used.

Result(s): Significantly higher implantation rate and PR were recorded in those who received low dose E2 supplementation compared with no substitution (PR 23.1% vs. 32.8%). The best implantation and pregnancy results were found significantly in the group with high dose E2 supplementation (PR 51.3%).

Conclusion(s): For women treated with a long GnRH analogue protocol for COH, addition of a high dose of E2 to daily P supplementation significantly improved the IVF-embryo transfer results.