Impact of luteal phase support on pregnancy rates in intrauterine insemination cycles: a prospective randomized study

Erdem, Ahmet; Erdem, Mehmet; Atmaca, Songul; Güler, İsmail

doi:10.1016/j.fertnstert.2008.04.029

Cited by 71 publications

(51 citation statements)

References 21 publications

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“…2b, 4 and 5). Besides, when performing a subgroup analysis on live birth per stimulation protocol, the trial using CC [23] did not show significant differences, while the two studies using rFSH [20,24] achieved significantly higher live births.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis

Miralpeix

González-Comadran

Solà

et al. 2013

J Assist Reprod Genet

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Purpose To evaluate the efficacy of luteal phase support with vaginal progesterone in women undergoing intrauterine insemination (IUI). Methods Systematic review and meta-analysis. Randomized controlled trials (RCT) comparing supplementation of luteal phase with vaginal progesterone among women undergoing IUI versus a control group were included. The main outcome assessed was live birth rate. Results Five RCT met the inclusion criteria. In all 1,271 patients were included (951 IUI cycles in the progesterone group, 935 in the control group). Women treated with vaginal progesterone achieved significantly higher live birth rate (risk ratio [RR] 1.94, 95 % confidence interval [CI] 1.36 to 2.77,), and clinical pregnancy rate (RR 1.41, 95 % CI 1.14 to 1.76) as compared with controls. In the subgroup analysis per stimulation protocol, this beneficial effect of receiving progesterone was only observed in the group stimulated with gonadotropins (RR 2.28, 95 % CI 1.49 to 3.51), compared to the group stimulated with clomiphene citrate (CC) (RR 1.30, 95 % CI 0.68 to 2.50). No differences were observed in the miscarriage and multiple pregnancy rates. Conclusions The supplementation of luteal phase with vaginal progesterone significantly increases live birth among women undergoing IUI when receiving gonadotropins for ovulation induction. Women receiving CC to induce ovulation do not seem to benefit from this treatment.Capsule Luteal phase support with vaginal progesterone in women undergoing intrauterine insemination significantly improves live birth rate. E. Miralpeix : M. González-Comadran : R. Carreras :

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Section: Discussionmentioning

confidence: 99%

“…In this regard, three of the trials included more than one cycle per woman proceeding to randomization per woman instead of per cycle. Thus, from the second cycle onward, depending on the trial's design, the patient either remained in the same group [23,24] or alternated groups subsequently [20], impeding the analysis per woman randomized.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis

Miralpeix

González-Comadran

Solà

et al. 2013

J Assist Reprod Genet

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“…In light of these evidences describing the physiological mechanisms leading to lower progesterone levels, the simple solution of providing the decreased progesterone led us to research the subject and deem if it is truly a beneficial treatment option. Though Erdem, Hamilton and various other authors are supporting progesterone supplementation, authors like Keenan, Moghissi and Ebrahimi are against it [7][8]; [9][10]. According to our study results we are in favor of progesterone supplementation.…”

Section: Resultsmentioning

confidence: 45%

“…There is also a debate on the way progesterone is administered. While Erdem et al suggests daily vaginal usage of 90 mg progesterone gel, Ebrahimi et al used daily vaginal usage of 400 mg of progesterone pessaries [8,10]. In our study group we preferred 100 mg of progesterone tablets orally thrice a day.…”

Section: Resultsmentioning

confidence: 91%

Progesterone Supplement and Luteal Phase Deficiency in Unifollicular Intrauterine Insemination Cycles

2015

Ann Clin Anal Med

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ÖzetAmaç: Intrauterin inseminasyon, diğer yardımcı üreme teknikleriyle karşılaş-tırıldığında, basit olması ve düşük maliyeti nedeniyle sıklıkla kulanılmaktadır. Anahtar KelimelerIntrauterin İnseminasyon; Progesteron; Luteal Faz; Unifoliküler Abstract Aim: Intrauterine insemination is a widely used technique with advantages of being a simple and less invasive method with a lower cost when compared to other assisted reproductive techniques. In the present prospective randomized controlled study we aim to prove that progesterone supplementation is a beneficial factor in pregnancies achieved with intra uterine insemination and also we want to emphasise that luteal phase deficiency does not always occur in multifollicular cycles but can be seen in unifollicular cycles as well. Material and Method: Patients diagnosed with unexplained infertility between December 2011 and December 2012 were admitted to the study group. 278 IUI cycles with COH using recombinant FSH induction were recorded. Results: The effect of progesterone supplement on achieving pregnancy was statistically significant (p<0.05) with a rate of 33.66% when compared to the non-receiving group that had a rate of 12.22%. Discussion: Progesterone supplementation, either in defective luteal phase or not has a chance of improving pregnancy rates in general and contrary to the notion that luteal phase deficiency mainly occurs in multifollicular cycles, it can be seen in unifollicular patients as well.

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“…It can be expected that sex steroid concentrations, both estradiol (E2 and progesterone), after multiple ovulation will be signifi cantly higher [ 42 ]. These high concentrations may not only infl uence the receptivity of the endometrium, but may also cause luteal insuffi ciency [ 43 ] as high concentrations of steroids through negative feedback on the pituitary-hypothalamic axis, inhibit the production of luteal LH, which is mandatory for luteal progesterone production. A signifi cant negative correlation has been reported between both pre-ovulatory estradiol concentrations and day 16 progesterone levels and the concentration of cytosolic progesterone receptor (Cpr) [ 44 ], while advanced endometrial maturity tends to be associated with low concentrations of cPR.…”

Section: Luteal Insuffi Ciency In Stimulated Cyclesmentioning

confidence: 99%

Progestogens in Infertility Practice

Patki

Sharma

2015

Progestogens in Obstetrics and Gynecology

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Impact of luteal phase support on pregnancy rates in intrauterine insemination cycles: a prospective randomized study

Cited by 71 publications

References 21 publications

Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis

Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis

Progesterone Supplement and Luteal Phase Deficiency in Unifollicular Intrauterine Insemination Cycles

Progestogens in Infertility Practice

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