Is Luteal Phase Estradiol Supplementation Beneficial in Long Agonist IVF-ET Cycles? First Prospective Randomised Controlled Study from Indian Subcontinent

Abstract

Introduction: The role of addition of estradiol to progesterone as luteal phase support in women undergoing In Vitro Fertilization (IVF) is not yet clear. Aim: To determine the efficacy of oral estradiol valerate in the luteal phase of IVF cycles. Materials and Methods: The randomized controlled study was done in the IVF centre of a Medical college. Total 150 women undergoing IVF were recruited, randomized in two groups, study (n=75) and control (n=75) using computerized randomization. Luteal phase support was started on day of Embryo Transfer (ET) : Study group-Estradiol valerate, 2mg bid orally+ Micronized progesterone, 400mg, bid vaginally and Control group: only Micronized progesterone, 400mg, bid vaginally. Blood samples for estimation of serum E2 were collected on day of oocyte retrieval, day of ET, three days after ET and on the day of confirmation of biochemical pregnancy. Statistical analysis was done using SPSS 16.0, p<0.05 was considered significant. Results: Overall pregnancy rate was 38.7% (58/150): study group (41.3%), control group (36%) (p-value = 0.50). Significantly higher E2 levels were found in women who conceived as compared to those who did not conceive. Conclusion: Although estradiol supplementation did not improve pregnancy rates significantly, but it certainly improved the hormonal profile in the study group compared with the control group.

Keywords

• estradiol valerate
• ethinyl estradiol levels
• mid luteal
• pregnancy rate
• progesterone