Immediate versus delayed progesterone supplementation in gamete intrafallopian transfer (GIFT)

Area of Science:

• Reproductive Endocrinology
• Human Assisted Reproduction

Background:

• Gamete intrafallopian transfer (GIFT) is an assisted reproductive technology.
• The role of exogenous progesterone (P) timing and its effect on endometrial receptivity and the isthmic block in GIFT remain areas for investigation.

Purpose of the Study:

• To determine the optimal timing for initiating exogenous progesterone supplementation in GIFT patients.
• To investigate the potential role of the isthmic block in the context of GIFT and progesterone administration.

Main Methods:

• Patients undergoing GIFT were randomized into two groups: immediate progesterone supplementation (from surgery day) and delayed supplementation (4 days post-surgery).
• Serum progesterone levels were monitored during the early luteal phase.
• Pregnancy and abortion rates were compared between the groups.

Main Results:

• The immediate group exhibited higher serum progesterone levels on luteal day 3 compared to the delayed group.
• No significant differences were observed in early luteal phase serum progesterone levels, pregnancy rates, or abortion rates between the two groups.
• Higher early luteal phase progesterone may enhance endometrial receptivity but potentially affects the isthmic block.

Conclusions:

• Initiating exogenous progesterone supplementation immediately or 4 days after GIFT surgery does not significantly impact pregnancy or abortion rates.
• The timing of progesterone supplementation may not be critical for successful implantation in GIFT cycles.
• Further research is warranted to elucidate the precise role of the isthmic block in GIFT procedures.