Luteal estradiol supplementation in gonadotropin-releasing hormone antagonist cycles for infertile patients in vitro fertilization
- PMID: 24179871
- PMCID: PMC3811722
- DOI: 10.5653/cerm.2013.40.3.131
Luteal estradiol supplementation in gonadotropin-releasing hormone antagonist cycles for infertile patients in vitro fertilization
Abstract
Objective: To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI.
Methods: One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared.
Results: Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010).
Conclusion: The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.
Keywords: Addition of estradiol; Gonadotropin-releasing hormone antagonist; In vitro fertilization; Intracytoplasmic sperm injection; Luteal progesterone supplementation.
Conflict of interest statement
No potential conflict of interest relevant to this article was reported.
Similar articles
-
Combined use of oestradiol and progesterone to support luteal phase in antagonist intracytoplasmic sperm injection cycles of normoresponder women: a case-control study.J Obstet Gynaecol. 2020 Feb;40(2):264-269. doi: 10.1080/01443615.2019.1631765. Epub 2019 Aug 28. J Obstet Gynaecol. 2020. PMID: 31455122
-
Luteal phase support with estradiol and progesterone versus progesterone alone in GnRH antagonist ICSI cycles: a randomized controlled study.Hum Fertil (Camb). 2016 Jun;19(2):142-9. doi: 10.1080/14647273.2016.1200145. Hum Fertil (Camb). 2016. PMID: 27434094 Clinical Trial.
-
Addition of estradiol to progesterone for luteal supplementation in patients stimulated with GnRH antagonist/rFSH for IVF: a randomized controlled trial.Hum Reprod. 2006 Oct;21(10):2628-32. doi: 10.1093/humrep/del117. Epub 2006 Jul 20. Hum Reprod. 2006. PMID: 16857887 Clinical Trial.
-
Luteal phase support in in vitro fertilization.Semin Reprod Med. 2015 Mar;33(2):118-27. doi: 10.1055/s-0035-1545363. Epub 2015 Mar 3. Semin Reprod Med. 2015. PMID: 25734349 Review.
-
GnRH Agonist Trigger and LH Activity Luteal Phase Support versus hCG Trigger and Conventional Luteal Phase Support in Fresh Embryo Transfer IVF/ICSI Cycles-A Systematic PRISMA Review and Meta-analysis.Front Endocrinol (Lausanne). 2017 Jun 7;8:116. doi: 10.3389/fendo.2017.00116. eCollection 2017. Front Endocrinol (Lausanne). 2017. PMID: 28638367 Free PMC article. Review.
Cited by
-
Plasmatic estradiol concentration in the mid-luteal phase is a good prognostic factor for clinical and ongoing pregnancies, during stimulated cycles of in vitro fertilization.JBRA Assist Reprod. 2018 Mar 1;22(1):8-14. doi: 10.5935/1518-0557.20180005. JBRA Assist Reprod. 2018. PMID: 29338136 Free PMC article.
-
The Relationship Between the Average Decreased Times of Estradiol and Early Miscarriage: An Observational Study.Reprod Sci. 2025 Feb;32(2):358-365. doi: 10.1007/s43032-024-01570-3. Epub 2024 May 6. Reprod Sci. 2025. PMID: 38710977 Free PMC article.
-
Estradiol Suppresses TLR4-triggered Apoptosis of Decidual Stromal Cells and Drives an Anti-inflammatory TH2 Shift by Activating SGK1.Int J Biol Sci. 2017 Mar 11;13(4):434-448. doi: 10.7150/ijbs.18278. eCollection 2017. Int J Biol Sci. 2017. PMID: 28529452 Free PMC article.
-
Estradiol use in the luteal phase and its effects on pregnancy rates in IVF cycles with GnRH antagonist: a systematic review.JBRA Assist Reprod. 2017 Sep 1;21(3):247-250. doi: 10.5935/1518-0557.20170046. JBRA Assist Reprod. 2017. PMID: 28837035 Free PMC article.
-
Luteal phase support for in vitro fertilization/intracytoplasmic sperm injection fresh cycles: a systematic review and network meta-analysis.Reprod Biol Endocrinol. 2021 Jul 6;19(1):103. doi: 10.1186/s12958-021-00782-5. Reprod Biol Endocrinol. 2021. PMID: 34229723 Free PMC article.
References
-
- Tavaniotou A, Albano C, Smitz J, Devroey P. Comparison of LH concentrations in the early and mid-luteal phase in IVF cycles after treatment with HMG alone or in association with the GnRH antagonist Cetrorelix. Hum Reprod. 2001;16:663–667. - PubMed
-
- Sharara FI, McClamrock HD. Ratio of oestradiol concentration on the day of human chorionic gonadotrophin administration to mid-luteal oestradiol concentration is predictive of in-vitro fertilization outcome. Hum Reprod. 1999;14:2777–2782. - PubMed
-
- Propst AM, Hill JA, Ginsburg ES, Hurwitz S, Politch J, Yanushpolsky EH. A randomized study comparing Crinone 8% and intramuscular progesterone supplementation in in vitro fertilization-embryo transfer cycles. Fertil Steril. 2001;76:1144–1149. - PubMed
-
- Engmann L, DiLuigi A, Schmidt D, Benadiva C, Maier D, Nulsen J. The effect of luteal phase vaginal estradiol supplementation on the success of in vitro fertilization treatment: a prospective randomized study. Fertil Steril. 2008;89:554–561. - PubMed
-
- Fauser BC, Devroey P. Reproductive biology and IVF: ovarian stimulation and luteal phase consequences. Trends Endocrinol Metab. 2003;14:236–242. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources
Research Materials