Effect Of Estradiol Progesterone Combination On Pregnancy In IVF-ICSI-ET Cycles
Research Article
DOI:
https://doi.org/10.5281/zenodo.8081453Keywords:
Infertility,, Pregnancy,, In-Vitro Fertilization,, Embryo Transfer, , Luteal Phase.Abstract
Objective: There are various treatment protocols in which different gonadotropins are used with or without pituitary down-regulation by using gonadotropin-releasing hormone (GnRH) agonists or antagonists. Since no single protocol suits every patient, the treatments should be individualized. Within the scope of this research, we aimed to elucidate the pregnancy rates achieved with progesterone and progesterone estradiol (E2) combination for luteal phase (LP) support in ICSI – ET cycles with ovarian hyperstimulation using GnRH analog were compared.
Materials & Methods: This study evaluated 142 infertile couples aged between 20 and 40. The patients' admission histories and physical and pelvic examination findings were recorded. Basal serum FSH, LH, E2, prolactin, TSH, and free T3 – T4 levels were measured in each patient on the second or third day of the cycle. A long protocol with GnRH agonist was applied to all patients.
Results: Of the 142 patients in the study, 71 were randomized (1:1) to receive vaginally gel progesterone and transdermal estrogen for luteal phase support, and 71 to receive gel progesterone vaginally. When the cycles with and without pregnancy were evaluated independently of the groups, a significant difference was found in terms of female age, male age, and mean gonadotropin amounts used (p<0.05). When the E2 measurements in the group with and without a pregnancy were examined, no significant difference was found in the basal E2 level, the E2 level on the hCG day, and the early luteal phase, that is, on the day of embryo transfer (p=0.788, p=0.735 and p=0.474, respectively). However, E2 levels were higher in pregnant women.
Conclusion: In conclusion, data showing the superiority of one gonadotropin option over another in IVF/ICSI treatment cycles are insufficient. The choice of gonadotropin in controlled ovarian stimulation depends on the product’s availability and should be based on ease of use and cost.
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