The effect of luteal phase support protocol on cycle outcome and luteal phase hormone profile in long agonist protocol intracytoplasmic sperm injection cycles: a randomized clinical trial

ObjectiveTo study the effect of luteal phase support protocol on cycle outcome and luteal phase hormone profile, in long agonist protocol intracytoplasmic sperm injection (ICSI) cycles.DesignProspective randomized trial.SettingPrivate infertility center.Patient(s)Two hundred seventy-four women undergoing first ICSI cycles were randomized after ovum pickup into three groups of luteal support.Intervention(s)Group I received IM P (P4) only, group II received P4 + oral E2 valerate, group III received P4 + hCG.Main Outcome Measure(s)Pregnancy rate (PR), implantation rate, rates of multiple pregnancy and miscarriage, and midluteal serum E2 and P4, and midluteal E2:P4 ratio.Result(s)The PR and implantation rates were significantly higher in group II compared to group I and the miscarriage rate was significantly lower in group II compared with group I. Midluteal E2 was significantly higher in group II compared with group I. The decline in E2 after ovum pickup was lowest in group II, highest in group I. The midluteal E2:P4 ratio was significantly higher in group II compared with groups I and III.Conclusion(s)The E2 luteal phase supplementation in long GnRH-agonist (GnRH-a) protocol ICSI cycles resulted in better cycle outcome and better luteal phase hormone profile.