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 E₂ to progestin supplementation during the luteal phase on pregnancy and implantation rates in patients undergoing IVF cycles. Design: Prospective, randomized study.Setting: An IVF unit in a university hospital. Patient(s): Patients who were undergoing IVF with controlled ovarian hyperstimulation using a GnRH analog and who had E₂ levels of >2, 500 pg/dL at the time of hCG administration. Intervention(s): Serum concentrations of E₂ and progesterone were measured in all patients on days 7, 10, and 12 after ET. Main Outcome Measure(s): The E₂ and progesterone profiles of the luteal phase and the pregnancy and implantation rates were documented. Data were analyzed for the entire study population and further stratified according to the GnRH analog protocol used (short or long). Result(s): Significantly higher E₂ levels were found during the luteal phase in the group that received E₂ supplementation. This effect was more pronounced in the patients who were treated with the long GnRH analog protocol. Significantly higher pregnancy and implantation rates were recorded in the patients who received E₂ supplementation and were treated with the long GnRH analog protocol. Conclusion(s): For patients who are treated with the long GnRH analog protocol for controlled ovarian hyperstimulation and for whom luteal support with hCG is contraindicated, the addition of E₂ to the progestin support regimen may have a beneficial effect on pregnancy and implantation rates. ũ 2000 American Society for Reproductive Medicine.