Early luteal progesterone supplementation during in vitro fertilization cycles. A randomized trial

The effects of early luteal phase progesterone (P) supplementation were studied in women with endogenous serum P levels less than or equal to 12 ng/mL prior to embryo transfer. From a total of 129 cycles that received the same ovarian hyperstimulation protocol, 72 cycles were characterized by levels less than 12 ng/mL on the day prior to embryo transfer. Of those women, 42 (group B) were started on P supplementation one day prior to embryo transfer, and 30 (group C) were started according to the standard protocol after embryo transfer. The clinical course and outcomes in both groups were compared with 57 cycles that had P levels greater than or equal to 12 ng/mL (group A). The early P supplementation in group B resulted in a transient increase in P levels on the morning of embryo transfer as compared with group C. It did not, however, approach the levels seen in group A, which had higher P levels from the early luteal phase through embryo transfer and more favorable oocyte recovery, fertilization and cleavage rates. We were unable to improve the clinical outcome in group B as compared with group C by providing earlier P supplementation.