Luteal phase support in in-vitro fertilization

Objective: To compare the clinical pregnancy rate after the use of human chorionic gonadotropin (hCG) injections (Profasi, Serono Pharmaceuticals), to that after the use of oral Duphaston (Duphaston, Solvay Pharmaceuticals B.V., Weesp, The Netherlands) , or vaginal Cyclogest (Cyclogest, Cox Pharmaceuticals, Barnstaple, Ex32 8NS, England) used for luteal phase support in in-vitro fertilization-embryo transfer (IVF-ET) cycles using gonadotropin- releasing hormone agonist. Study design: A retrospective cohort study.
Setting: Tawam Hospital Fertility Clinic (a tertiary referral center) in the United Arab Emirates.
Materials and methods: A total of 305 consecutive IVF/ET cycles from 1st of January to 31st of May 2000 were included in the study. All women were < 40 years of age. 201 women were treated with hCG (66%) at a dose of 1,500-2,500 IU intramuscular (IM) given every second or third day for three to five doses. 44 women were treated with oral Duphaston (14.4%) given at a dose of 40mg/day and 60 were given vaginal Cyclogest pessaries (19.6%) at a dose of 400mg twice daily, until the date of the pregnancy test. Student t test was used for statistical analysis to measure significance.
Main outcome measures: Clinical pregnancy rate.
Results: The use of IM hCG for luteal phase support in IVF-ET cycles was associated with similar clinical pregnancy rate compared with vaginal Cyclogest pessaries and oral progesterone (Duphaston) (24.9%, 28.3% and 25% respectively), (P=1.000and P= 0.359).
Conclusion: There is no significant difference in clinical pregnancy rate when different modalities of luteal phase support medications are used in IVF-ET cycles like hCG, oral Duphaston and vaginal Cyclogest. This conclusion is affected by the small number of studied cycles and the study design being retrospective.