THE ROLE OF ESTROGEN SUPPORT DURING THE LUTEAL-PHASE OF IN-VITRO FERTILIZATION-EMBRYO TRANSPLANT CYCLES - A COMPARATIVE-STUDY BETWEEN PROGESTERONE ALONE AND ESTROGEN AND PROGESTERONE SUPPORT

Objective: To evaluate the possible role for estrogen supplementation to the P luteal phase support of GnRH agonists (GnRH-a)- and hMG-induced IVF-ET cycles. Setting: In vitro fertilization unit in a tertiary care university hospital. Design: A prospectively randomized study. Patients: One hundred consecutive patients undergoing ET after IVF were assigned into one of two luteal supplementation regimens. Interventions: In all patients enrolled in the study, ovulation was induced using the midluteal regimen for pituitary down regulation with GnRH-a followed by follicular stimulation with hMG. The first group received IM P 50 mg/d, as luteal phase support, starting the day of ET. The second group received the same dosage of P, combined with oral E(2) valerate, 2 mg/d. Serum levels of P and E(2) were monitored every 4 days for 16 days after ET. Main Outcome Measures: Pregnancy rates (PRs) and live birth rates per ET. Results: No significant difference in E(2) or P levels throughout the cycle was observed between groups. Similar PRs per ET and the live birth rates were also observed between group A and B (28% versus 26.5% and 78.6% versus 76.1%, respectively). Conclusion: No advantage was found in the addition of E(2) valerate to P luteal phase support of GnRH-a- and hMG-induced IVF-ET cycles.