Effect of estradiol supplementation on luteal support following a significant reduction in serum estradiol levels after hCG triggering: a prospective randomized controlled trial.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101153627 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7827 (Electronic) Linking ISSN: 14777827 NLM ISO Abbreviation: Reprod Biol Endocrinol Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, 2003-
    • Subject Terms:
      Estradiol*/blood ; Estradiol*/administration & dosage ; Pregnancy Rate* ; Chorionic Gonadotropin*/administration & dosage ; Luteal Phase*/drug effects ; Luteal Phase*/blood ; Fertilization in Vitro*/methods ; Progesterone*/blood ; Progesterone*/administration & dosage ; Ovulation Induction*/methods; Humans ; Female ; Pregnancy ; Adult ; Prospective Studies ; Embryo Transfer/methods ; Oocyte Retrieval/methods
    • Abstract:
      Objective: This study aimed to evaluate the impact of adding 4 mg estradiol valerate to progesterone for luteal support on pregnancy rates in IVF cycles following a long protocol with reduced luteal serum estradiol levels post-hCG triggering.
      Design, Setting, and Participants: The prospective randomized controlled trial was conducted at a public tertiary hospital reproductive center with 241 patients who experienced a significant decrease in serum estrogen levels post-oocyte retrieval.
      Interventions: Participants received either a daily 4 mg dose of estradiol valerate in addition to standard progesterone or standard progesterone alone for luteal support.
      Results: The ongoing pregnancy rate did not show a significant difference between the E2 group and the control group (56.6% vs. 52.2%, with an absolute rate difference (RD) of 4.4%, 95% CI -0.087 to 0.179, P = 0.262). Similarly, the live birth rate, implantation rate, clinical pregnancy rate, early abortion rate, and severe OHSS rate were comparable between the two groups. Notably, the E2 group had no biochemical miscarriages, contrasting significantly with the control group (0.0% vs. 10.7%, RD -10.7%, 95% CI -0.178 to -0.041, P = 0.000). In the blastocyst stage category, the clinical pregnancy rate was notably higher in the E2 group compared to the control group (75.6% vs. 60.8%, RD 14.9%, 95% CI 0.012 to 0.294, P = 0.016).
      Conclusion: Adding 4 mg estradiol valerate to progesterone for luteal support does not affect the ongoing pregnancy rate in embryo transfer cycles using a long protocol with a significant decrease in serum estradiol levels after hCG triggering. However, it may reduce biochemical miscarriages and positively impact clinical pregnancy rates in blastocyst embryo transfer cycles.
      Trial Registration: ChiCTR1800020342.
      (© 2024. The Author(s).)
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    • Grant Information:
      2018D035 Shaanxi Health Research Fund Project; 2018D035 Shaanxi Health Research Fund Project; 2018D035 Shaanxi Health Research Fund Project
    • Contributed Indexing:
      Keywords: Estradiol supplementation; Luteal phase support; Ongoing pregnancy rate; Serum estradiol drop
    • Accession Number:
      4TI98Z838E (Estradiol)
      0 (Chorionic Gonadotropin)
      4G7DS2Q64Y (Progesterone)
    • Publication Date:
      Date Created: 20240912 Date Completed: 20240913 Latest Revision: 20241122
    • Publication Date:
      20241122
    • Accession Number:
      PMC11391712
    • Accession Number:
      10.1186/s12958-024-01275-x
    • Accession Number:
      39267070