Early progesterone cessation after in vitro fertilization/intracytoplasmic sperm injection: a randomized, controlled trial

Abstract

Objective: To investigate the effect of stopping progesterone (P) support at week 5 versus week 8 on ongoing pregnancy rate after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

Design: Prospective, randomized, controlled trial.

Setting: University-affiliated infertility center.

Patient(s): A total of 220 patients with intrauterine pregnancy demonstrated by transvaginal ultrasound after IVF/ICSI.

Intervention(s): Luteal phase support with micronized vaginal P was suspended at week 5 or at week 8.

Main outcome measure(s): Ongoing pregnancy rate, miscarriage rate, and number of bleeding episodes.

Result(s): Progesterone levels were similar on the day of the first pregnancy ultrasound exam (149 ± 108 vs. 167 ± 115 ng/mL). Significantly more bleeding episodes were observed in the first trimester in the group with early cessation of P supplementation (18.0 ± 2.6 vs. 7.2 ± 1.3 episodes). Miscarriage rates among singleton pregnancies were similar in the two groups (5/80 vs. 6/79).

Conclusion(s): Vaginal P supplementation after IVF/ICSI can be safely withdrawn at 5 weeks' gestation, because cycle outcome was similar to conventional luteal phase support up to 8 weeks of pregnancy.

Clinical trial registration number: NCT01177904.