Çakar Erbil, Tasan Habibe Ayvaci, Kumru Pınar, Cogendez Ebru, Usal Nazan Tarhan, Kutlu Hüseyin Tayfun, Özkaya Enis, Eser Semra Kayatas
Zeynep Kamil Women and Children's Diseases Training and Research Hospital, IVF Center, Istanbul, Turkey.
J Obstet Gynaecol. 2020 Feb;40(2):264-269. doi: 10.1080/01443615.2019.1631765. Epub 2019 Aug 28.
We evaluated the effect of combined use of oral oestrogen (E2) and vaginal progesterone (P) to support luteal phase in antagonist intracytoplasmic sperm injection (ICSI) cycles. We analysed data from 176 patients who underwent ICSI cycles with antagonist protocol. P 90 mg vaginal gel once a day and micronised E2 of 4 mg/day, were started from the day of oocyte pick up and continued to the 12th day of embryo transfer. Group 1 ( = 79) patients received E2 + P for luteal phase support. In group 2 ( = 97) patients, only P 90 mg vaginal gel was used for luteal phase support. There were no significant differences between group 1 and group 2 patients in terms of clinical pregnancy rates (PRs) (26.58% vs. 20.62%, = .352), early pregnancy loss rates (6.33% vs. 6.19%, = .969), incidence of luteal vaginal bleeding (8.86% vs. 8.25%, = .885) and implantation rates (22.8% vs. 16.9%, = .298). In conclusion, our study showed no beneficial effect of addition of E2 to luteal phase support on clinical PR in antagonist IVF cycles.Impact statement Luteal phase deficiency is defined as a disruption in progesterone and oestrogen production after ovulation. It is clear that, luteal phase supplementation to improve the outcomes in fertilisation (IVF) cycles is mandatory. As an iatrogenic complication of assisted reproductive technique, decreased luteal oestrogen and progesterone levels lead to decreased pregnancy rates (PRs) and implantation rates. In this study, we aimed to present the role of luteal phase oestrogen administration in GnRH antagonist cycles. A total of 176 cases received progesterone vaginal gel form for luteal phase support. Study group received 4 mg oral oestradiol hemihydrate in addition to progesterone. Compared to previous studies, our study consisted of larger number of patients and we used oestradiol through oral route. We found out that luteal oestradiol support did not improve the clinical PR. Our study showed no beneficial effect of addition of oestradiol to luteal phase support on clinical PR in antagonist IVF cycles.
我们评估了口服雌激素（E2）和阴道用孕激素（P）联合使用在拮抗剂方案的卵胞浆内单精子注射（ICSI）周期中支持黄体期的效果。我们分析了176例接受拮抗剂方案ICSI周期治疗患者的数据。从取卵日开始，每天一次阴道用90毫克凝胶P和4毫克/天的微粒化E2，并持续至胚胎移植的第12天。第1组（n = 79）患者在黄体期支持时接受E2 + P。在第2组（n = 97）患者中，仅使用90毫克阴道凝胶P进行黄体期支持。第1组和第2组患者在临床妊娠率（PRs）（26.58%对20.62%，P = 0.352）、早期妊娠丢失率（6.33%对6.19%，P = 0.969）、黄体期阴道出血发生率（8.86%对8.25%，P = 0.885）和种植率（22.8%对16.9%，P = 0.298）方面无显著差异。总之，我们的研究表明，在拮抗剂IVF周期中，黄体期支持添加E2对临床PR没有有益影响。影响声明黄体期缺陷被定义为排卵后孕酮和雌激素产生的中断。显然，补充黄体期以改善体外受精（IVF）周期的结局是必要的。作为辅助生殖技术的医源性并发症，黄体期雌激素和孕酮水平降低导致妊娠率（PRs）和种植率下降。在本研究中，我们旨在阐述黄体期给予雌激素在GnRH拮抗剂周期中的作用。共有176例患者接受阴道用凝胶形式的孕酮进行黄体期支持。研究组除接受孕酮外，还接受4毫克口服半水合雌二醇。与以往研究相比，我们的研究纳入了更多患者，并且我们通过口服途径使用雌二醇。我们发现黄体期给予雌二醇并不能改善临床PR。我们的研究表明，在拮抗剂IVF周期中，黄体期支持添加雌二醇对临床PR没有有益影响。
