Na Huang1, Bing Situ2, Xiao Chen3, Jianqiao Liu4, Pengke Yan2, Xinhuang Kang1, Songzhi Kong1, Min Huang5. 1. College of Science, Guangdong Ocean University, Zhanjiang, People's Republic of China. 2. Department of Pharmacy, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China. 3. Department of Pharmacy, The First Affliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China. 4. Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China. 5. Insititute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address: huangmin@mail.sysu.edu.cn.
Abstract
OBJECTIVE: To evaluate whether the addition of E(2) for luteal phase support (LPS) in IVF/intracytoplasmic sperm injection (ICSI) could improve the outcome of clinical pregnancy. DESIGN: Meta-analysis. SETTING: University hospital center. PATIENT(S): Women underwent IVF or ICSI using the GnRH agonist or GnRH antagonist protocol. INTERVENTION(S): Progesterone alone or combined with E(2) for LPS. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate per patient (CPR/PA), clinical pregnancy rate per ET, implantation rate, ongoing pregnancy rate per patient, clinical abortion rate, and ectopic pregnancy rate. RESULT(S): Fifteen relevant randomized controlled trials (RCTs) were identified that included a total of 2,406 patients. There was no statistical difference between E(2) + P group and P-only group regarding the primary outcome of CPR/PA for different routes of administration of E(2) (oral, vaginal, and transdermal) or other relevant outcome measures. No significant effect was observed for different daily doses of E(2) (6, 4, and 2 mg), even through oral medication in CPR/PA. CONCLUSION(S): The best available evidence suggests that E(2) addition during the luteal phase does not improve IVF/ICSI outcomes through oral medication, even with different daily doses. Furthermore, RCTs that study other administration routes are needed.
OBJECTIVE: To evaluate whether the addition of E(2) for luteal phase support (LPS) in IVF/intracytoplasmic sperm injection (ICSI) could improve the outcome of clinical pregnancy. DESIGN: Meta-analysis. SETTING: University hospital center. PATIENT(S): Women underwent IVF or ICSI using the GnRH agonist or GnRH antagonist protocol. INTERVENTION(S): Progesterone alone or combined with E(2) for LPS. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate per patient (CPR/PA), clinical pregnancy rate per ET, implantation rate, ongoing pregnancy rate per patient, clinical abortion rate, and ectopic pregnancy rate. RESULT(S): Fifteen relevant randomized controlled trials (RCTs) were identified that included a total of 2,406 patients. There was no statistical difference between E(2) + P group and P-only group regarding the primary outcome of CPR/PA for different routes of administration of E(2) (oral, vaginal, and transdermal) or other relevant outcome measures. No significant effect was observed for different daily doses of E(2) (6, 4, and 2 mg), even through oral medication in CPR/PA. CONCLUSION(S): The best available evidence suggests that E(2) addition during the luteal phase does not improve IVF/ICSI outcomes through oral medication, even with different daily doses. Furthermore, RCTs that study other administration routes are needed.
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