Meta-analysis of estradiol for luteal phase support in in vitro fertilization/intracytoplasmic sperm injection
Na Huang1, Bing Situ2, Xiao Chen3
1College of Science, Guangdong Ocean University, Zhanjiang, People's Republic of China.
Objective:
To evaluate whether the addition of E(2) for luteal phase support (LPS) in IVF/intracytoplasmic sperm injection (ICSI) could improve the outcome of clinical pregnancy.
Design:
Meta-analysis.
Setting:
University hospital center.
Patient(S):
Women underwent IVF or ICSI using the GnRH agonist or GnRH antagonist protocol.
Intervention(S):
Progesterone alone or combined with E(2) for LPS.
Main Outcome Measure(S):
Clinical pregnancy rate per patient (CPR/PA), clinical pregnancy rate per ET, implantation rate, ongoing pregnancy rate per patient, clinical abortion rate, and ectopic pregnancy rate.
Result(S):
Fifteen relevant randomized controlled trials (RCTs) were identified that included a total of 2,406 patients. There was no statistical difference between E(2) + P group and P-only group regarding the primary outcome of CPR/PA for different routes of administration of E(2) (oral, vaginal, and transdermal) or other relevant outcome measures. No significant effect was observed for different daily doses of E(2) (6, 4, and 2 mg), even through oral medication in CPR/PA.
Conclusion(S):
The best available evidence suggests that E(2) addition during the luteal phase does not improve IVF/ICSI outcomes through oral medication, even with different daily doses. Furthermore, RCTs that study other administration routes are needed.
