The Effects of Three Methods of Luteal Phase Support on Pregnancy Outcomes in Poor Ovarian Responders: A Randomized Clinical Trial
Background: The effectiveness of changing the type of luteal phase support in patients with poor ovarian response(POR) remains unclear based on the available evidence. This study aimed to compare the effectiveness of variousluteal phase support (LPS) methods, including progesterone alone, human chor...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Royan Institute (ACECR), Tehran
2025-01-01
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| Series: | International Journal of Fertility and Sterility |
| Subjects: | |
| Online Access: | https://www.ijfs.ir/article_712719_32ad0cdc3701a3798e3d698ff1a2b20a.pdf |
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| Summary: | Background: The effectiveness of changing the type of luteal phase support in patients with poor ovarian response(POR) remains unclear based on the available evidence. This study aimed to compare the effectiveness of variousluteal phase support (LPS) methods, including progesterone alone, human chorionic gonadotropin (hCG) alone,and the combination of progesterone with hCG, in these patients.Materials and Methods: In this randomized clinical trial, 375 patients diagnosed with POR based on the Bolognacriteria underwent intracytoplasmic sperm injection-embryo transfer (ET) cycles at the Royan Institute betweenNovember 2015 and June 2019. The patients were allocated randomly into three different LPS groups on the day ofoocyte pickup. In the first group, 1500 IU of hCG on the ET day, as well as 4 days after that were administrated intramuscularly.In the second group, the patients received 1500 IU of hCG IM on the ET day, as well as 3 and 6 daysafter the ET along with vaginal progesterone suppositories of 400 mg twice daily. For the third group, only vaginalsuppositories twice daily were administrated from the day of oocyte pick up until the pregnancy test day. The clinicalpregnancy, miscarriage and live birth rates were compared among groups using appropriate statistical tests.Results: The data analysis indicated that the three groups were comparable, and there were no significant differencesamong the groups in terms of implantation, clinical pregnancy, miscarriage, and live birth rates. The twinpregnancy rate in the hCG-only group was higher than in the other two groups, although this difference did notreach statistical significance (P=0.060).Conclusion: Similar pregnancy and live birth rates were observed among different LPS regimens. Interestingly,the use of two boluses of low-dose hCG (1500) was associated with a slight increase in multiple pregnancies. Wesuggest this effective method, which is easier and more patient-friendly (registration number: NCT02798653). |
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| ISSN: | 2008-076X 2008-0778 |