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Hum. Reprod. Advance Access originally published online on February 11, 2008
Human Reproduction 2008 23(4):857-862; doi:10.1093/humrep/den012
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Prospective randomized study comparing luteal phase support for ICSI patients up to the first ultrasound compared with an additional three weeks

Mohamed A. Aboulghar1, Yahia M. Amin, Hesham G. Al-Inany, Mona M. Aboulghar, Latouna M. Mourad, Gamal I. Serour and Ragaa T. Mansour

The Egyptian IVF-ET Centre, 3 St. 161 Hadaek El-Maadi, Maadi, Cairo 11431, Egypt; Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt

1 Correspondence address. Tel: +20-2-25254944; Fax: +20-02-25253532; E-mail: ghar{at}link.net

BACKGROUND: There is a consensus that administration of progesterone to women after IVF for luteal phase support (LPS) is associated with a higher ongoing pregnancy rate. However there are few studies, including only one randomized study, which have examined the optimal duration of LPS.

METHODS: A questionnaire concerning details of LPS was returned from 21 leading IVF centres. We then randomized 257 women, who were pregnant after ICSI on day of first ultrasound, into two groups: to continue LPS for three more weeks or to stop on the day of ultrasound.

RESULTS: The duration of LPS in the questionnaire varied from the day of positive pregnancy test up to 12 weeks of pregnancy in different centres. In the randomized sutdy, 132 patients in Group A continued LPS for 3 weeks after first ultrasound, whereas 125 patients in Group B stopped LPS on day of first ultrasound. After confirming pulsations, the miscarriage rate up to 20 weeks of gestation was 4.6% (6/132) in group A and 4.8% (6/125) in group B [odds ratios (OR) = 0.94; 95% confidence intervals (CI) = 0.3–3.1]. Bleeding episodes were 15.9% in Group A compared with 20.8% in group B (OR = 0.72; 95% CI = 0.38–1.36).

CONCLUSIONS: There is no international consensus about the duration of LPS; our single-centre randomized trial did not support extending the LPS beyond the day of first ultrasound demonstrating echoes and pulsations. Trials registry number–ISRCTN: 88722916.

Key words: luteal phase support/progesterone/early pregnancy/miscarriage/bleeding eposodes

Submitted on October 11, 2007; resubmitted on December 16, 2007; accepted on January 9, 2008.


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