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Human Reproduction, Vol. 8, No. 1, pp. 40-45, 1993
© 1993 European Society of Human Reproduction and Embryology

other

A prospective randomized study on oestradiol valerate supplementation in addition to intravaginal micronized progesterone in buserelin and HMG induced superovulation

J. Smitz1, C. Bourgain2, L. van Waesberghe, M. Camus, P. Devroey and A.C. Van Steirteghem

Centre for Reproductive Medicine, Akademisch Ziekenhuis, Laarbeeklaan 101 B-1090 Brussels, Belgium 2Department of Pathology, Vrije Universiteit Brussel B-1090 Brussels, Belgium

Correspondence: 1To whom correspondence should be addressed

A prospective randomized study was conducted to evaluate the use of adding oestradiol valerate 6 mg per os daily to intravaginal micronized progesterone (600 mg daily) as luteal supplements. The study comprised 378 infertile women superovulated with a gonadotrophin releasing-hormone agonist (GnRHa) and human menopausal gonadotrophins (HMG) for in-vitro fertilization (IVF) or zygote intra-Fallopian transfer (ZIFT). The clinical pregnancy rate was similar (29%) whether or not oestradiol valerate was added to intravaginal progesterone. Eighteen out of twenty-two endometrial biopsies were in phase, and morphological evaluations of the two luteal supplementation groups were not different. Serum hormone profiles in singleton pregnancies showed a similar day of appearance of human chorionic gonadotrophin (HCG) in both protocols but significantly lower oestradiol concentrations arose in the group without oestradiol valerate. In 32% of the singleton pregnancies, the first appearance of HCG occurred later than day 12 after HCG injection; in those ongoing pregnancies, corpus luteum rescue—as measured by significantly lower serum oestradiol and progesterone concentrations—was compromised. This study provided no evidence of any benefit of routinely supplementing GnRHa/HMG cycles with oestradiol valerate in addition to intravaginal micronized progesterone.

Key words: GnRH agonists/HCG/IVF/luteal phase/oestradiol valerate


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