No need for luteal phase support in IVF cycles after mild stimulation: proof-of-concept study

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)

Background:

• Luteal support is a common practice in IVF cycles to enhance implantation and pregnancy rates.
• Conventional ovarian stimulation protocols often lead to a luteal phase defect, necessitating exogenous hormone support.

Purpose of the Study:

• To investigate the requirement for luteal support in IVF cycles utilizing mild stimulation protocols.
• To assess the hormonal milieu during the luteal phase following mild stimulation with clomiphene citrate and low-dose FSH.

Main Methods:

• Pilot study in a private IVF unit involving 15 good-prognosis patients undergoing mild stimulation IVF.
• Monitoring of serum progesterone and LH levels during the luteal phase.
• Luteal support was administered only if clinically indicated.

Main Results:

• None of the 15 patients required luteal phase support.
• The live birth rate was 40% (6/15) and the implantation rate was 30% (6/20).
• The steroid environment post-mild stimulation differed from that seen in conventional stimulation.

Conclusions:

• Mild stimulation protocols may naturally support the luteal phase, potentially obviating the need for exogenous luteal support.
• Benefits of mild stimulation include reduced cost, patient distress, and improved endometrial receptivity.
• This pilot study suggests mild stimulation IVF is a viable option with favorable outcomes and reduced intervention.