Delaying the initiation of progesterone supplementation results in decreased pregnancy rates after in vitro fertilization: a randomized, prospective study
Sc. Williams et al., Delaying the initiation of progesterone supplementation results in decreased pregnancy rates after in vitro fertilization: a randomized, prospective study, FERT STERIL, 76(6), 2001, pp. 1140-1143
Objective: To compare lVF outcome between two protocols for luteal phase Su
pplementation, one beginning on day 3 after oocyte retrieval and the other
beginning on day 6 after retrieval.
Design: Prospective, randomized study.
Setting: University-based assisted reproductive technology center.
Patient(s): One hundred twenty-six consecutive patients undergoing TVF betw
een January and July 2000.
Intervention(s): Patients were randomized to be-in luteal phase support usi
ng vaginal progesterone beginning either on day 3 after oocyte retrieval or
on day 6 after oocyte retrieval.
Main Outcome Measure(s): Clinical pregnancy rates and implantation rates.
Result(s): All patients randomized underwent transfer. There were no differ
ences in age, oocytes retrieved, or embryos transferred between the two gro
ups. Those patients receiving luteal phase support with progesterone beginn
ing on day 6 after retrieval had a significantly lower clinical pregnancy r
ate per transfer compared with those beginning support on day 3 after retri
eval (44.8% vs. 61.0%, respectively). This difference in pregnancy rates wa
s greater in those patients undergoing a luteal gonadotropin releasing horm
one (GnRH) agonist down-regulation protocol (47.5% vs. 71.4%, day 6 vs. day
3, respectively). Beginning support on day 6 also significantly decreased
implantation rates in the GnRH agonist group (21.0% vs. 34.0%, day 6 vs. da
y 3, respectively).
Conclusion(s): Pregnancy rates are significantly decreased by initiating lu
teal-phase progesterone supplementation on day 6 after oocyte retrieval dur
ing in vitro fertilization cycles. (Fertil Steril (R) 2001;76:1140-3. (C) 2
001 by American Society for Reproductive Medicine.).