OBJECTIVE: To evaluate the effectiveness of transdermal E(2) administration in the luteal phase of IVF/ICSI cycles. DESIGN: Prospective, open-label, randomized clinical trial. SETTING:University-affiliated assisted reproduction center. PATIENTS: 1) Pilot trial to test serum E(2) behaviour during the luteal phase in women undergoing agonist as well as antagonist protocol; 2) women undergoing IVF/ICSI with good-quality embryos available. INTERVENTION(S): One hundred seventy-six patients were randomized by random number list on the day of embryo transfer to either: 1) progesterone (P) only as luteal support (200 mg bid starting the following night after oocyte retrieval); or 2) E(2) and P combined, applying E(2) patches (100 microg/day) twice per week beginning on the day of embryo transfer with P, as in the P-only group. MAIN OUTCOME MEASURE(S): The primary outcome was implantation rate per embryo transfer; secondary outcome variables were pregnancy rate per embryo transfer, early pregnancy loss, multiple pregnancy rate, and midluteal P and E(2) levels. RESULT(S): Hormonal levels did not differ between groups. There were no statistically significant differences in terms of implantation rate (34.9% [51 of 146] vs. 28.9% [41 of 142]), ongoing pregnancy rate 42% ([34 of 81] vs. 41.8% [33 of 79]), early pregnancy loss (15% [6 of 40] vs. 13.2% [5 of 38]), or multiple pregnancy rate (28.6% [12 of 42] vs. 24.4% [10/41]) in patients receiving P versus E(2) + P. CONCLUSION(S): The addition of transdermal E(2) to the luteal-phase P support of IVF cycles did not improve cycle outcomes in terms of implantation and pregnancy rates.
RCT Entities:
OBJECTIVE: To evaluate the effectiveness of transdermal E(2) administration in the luteal phase of IVF/ICSI cycles. DESIGN: Prospective, open-label, randomized clinical trial. SETTING: University-affiliated assisted reproduction center. PATIENTS: 1) Pilot trial to test serum E(2) behaviour during the luteal phase in women undergoing agonist as well as antagonist protocol; 2) women undergoing IVF/ICSI with good-quality embryos available. INTERVENTION(S): One hundred seventy-six patients were randomized by random number list on the day of embryo transfer to either: 1) progesterone (P) only as luteal support (200 mg bid starting the following night after oocyte retrieval); or 2) E(2) and P combined, applying E(2) patches (100 microg/day) twice per week beginning on the day of embryo transfer with P, as in the P-only group. MAIN OUTCOME MEASURE(S): The primary outcome was implantation rate per embryo transfer; secondary outcome variables were pregnancy rate per embryo transfer, early pregnancy loss, multiple pregnancy rate, and midluteal P and E(2) levels. RESULT(S): Hormonal levels did not differ between groups. There were no statistically significant differences in terms of implantation rate (34.9% [51 of 146] vs. 28.9% [41 of 142]), ongoing pregnancy rate 42% ([34 of 81] vs. 41.8% [33 of 79]), early pregnancy loss (15% [6 of 40] vs. 13.2% [5 of 38]), or multiple pregnancy rate (28.6% [12 of 42] vs. 24.4% [10/41]) in patients receiving P versus E(2) + P. CONCLUSION(S): The addition of transdermal E(2) to the luteal-phase P support of IVF cycles did not improve cycle outcomes in terms of implantation and pregnancy rates.
Authors: Sara Pinelli; Paolo Giovanni Artini; Stefano Basile; Maria Elena Rosa Obino; Claudia Sergiampietri; Diana Giannarelli; Giovanna Simi; Vito Cela Journal: J Assist Reprod Genet Date: 2017-12-05 Impact factor: 3.412
Authors: Michelle van der Linden; Karen Buckingham; Cindy Farquhar; Jan A M Kremer; Mostafa Metwally Journal: Cochrane Database Syst Rev Date: 2015-07-07
Authors: Rodopiano S Florêncio; Melaynne S B Meira; Marcos V da Cunha; Mylena N C R Camarço; Eduardo C Castro; Marta C C F Finotti; Vinicius A de Oliveira Journal: JBRA Assist Reprod Date: 2018-03-01