Impact of luteal phase support with vaginal progesterone on the clinical pregnancy rate in intrauterine insemination cycles stimulated with gonadotropins: a randomized multicenter study

Karen Peeraer, Thomas D’Hooghe, Thomas D'Hooghe, Pascale Laurent, Sofie Pelckmans, Annick Delvigne, Annouschka Laenen, Myriam Welkenhuysen, Christine Wyns, Diane De Neubourg
Fertility and sterility · 2016 · vol. 106(6) , pp. 1490–1495 · doi:10.1016/j.fertnstert.2016.07.1096 · PMID:27565253 · W2516674675
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This randomized trial found vaginal progesterone luteal phase support did not significantly increase clinical pregnancy or live birth rates in gonadotropin-stimulated intrauterine insemination cycles, though it did lengthen the luteal phase.

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Abstract

OBJECTIVE: To evaluate the effect of luteal phase support (LPS) in intrauterine insemination (IUI) cycles stimulated with gonadotropins. DESIGN: Randomized multicenter trial. SETTING: Academic tertiary care centers and affiliated secondary care centers. PATIENT(S): Three hundred and ninety-three normo-ovulatory patients, <43 years, with body mass index ≤30 kg/m2, in their first IUI cycle, with at least one patent tube, a normal uterine cavity, and a male partner with total motile sperm count ≥5 million after capacitation. INTERVENTION(S): Gonadotropin stimulation, IUI, randomization to LPS using vaginal progesterone gel (n = 202) or no LPS (n = 191). MAIN OUTCOME MEASURE(S): Clinical pregnancy rate, live-birth rate, miscarriage rate, and duration of the luteal phase. RESULT(S): The primary outcome, the clinical pregnancy rate, was not statistically different between the treatment group (16.8%) and the control group (11%) (relative risk [RR] 1.54; 95% confidence interval [CI], 0.89-2.67). Similarly, the secondary outcome, the live-birth rate, was 14.9% in the treatment group and 9.4% in the control group (RR 1.60; 95% CI, 0.89-2.87). The mean duration of the luteal phase was about 2 days longer in the treatment group (16.6 ± 2.2 days) compared with the control group (14.6 ± 2.5 days) (mean difference 2.07; 95% CI, 1.58-2.56). CONCLUSION(S): Although a trend toward a higher clinical pregnancy rate as well as live-birth rate was observed in the treatment group, the difference with the control group was not statistically significant. CLINICAL TRIAL REGISTRATION NUMBER: NCT01826747.

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MeSH descriptors

Fertility Agents, Female Gonadotropins Infertility Insemination, Artificial, Homologous Luteal Phase Progesterone Abortion, Spontaneous Abortion, Spontaneous Administration, Intravaginal Adult Female Fertility Fertility Agents, Female Gels Gonadotropins Humans Infertility Infertility Infertility Live Birth

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