Estradiol supplementation during the luteal phase may improve the pregnancy rate in patients undergoing in vitro fertilization-embryo transfer cycles

Objective: To evaluate the effect of adding E-2 to progestin supplementatio n during the luteal phase on pregnancy and implantation rates in patients u ndergoing IVF cycles. Design: Prospective, randomized study. Setting: An IVF unit in a university hospital. Patient(s): Patients who were undergoing IVF with controlled ovarian hypers timulation using a GnRH analog and who had E-2 levels of >2,500 pg/dL at th e time of hCG administration. Intervention(s): Serum concentrations of E-2 and progesterone were measured in all patients on days 7, 10, and 12 after ET. Main Outcome Measure(s): The E-2 and progesterone profiles of the luteal ph ase and the pregnancy and implantation rates were documented. Data were ana lyzed for the entire study population and further stratified according to t he GnRH analog protocol used (short or long). Result(s): Significantly higher E-2 levels were found during the luteal pha se in the group that received E-2 supplementation. This effect was more pro nounced in the patients who were treated with the long GnRH analog protocol . Significantly higher pregnancy and implantation rates were recorded in th e patients who received E-2 supplementation and were treated with the long GnRH analog protocol. Conclusion(s): For patients who are treated with the long GnRH analog proto col for controlled ovarian hyperstimulation and for whom luteal support wit h hCG is contraindicated, the addition of E-2 to the progestin support regi men may have a beneficial effect on pregnancy and implantation rates. (C) 2 000 by American Society for Reproductive Medicine.