Metaanalysis of estradiol for luteal phase support in in vitro fertilization intracytoplasmic sperm injection

Capsule:
This meta-analysis suggests that estradiol addition during the luteal phase does not improve in vitro fertilization/intracytoplasmic sperm injection outcomes through oral medication, even with different daily doses.

Authors:
Na Huang, M.S., Bing Situ, M.S., Xiao Chen, Ph.D., Jianqiao Liu, M.D., Pengke Yan, M.D., Ph.D., Xinhuang Kang, Ph.D., Songzhi Kong, Ph.D., Min Huang, Ph.D.

Volume 103, Issue 2, Pages 367-373

Abstract:

Objective:
To evaluate whether the addition of E2 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 E2 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 E2 + P group and P-only group regarding the primary outcome of CPR/PA for different routes of administration of E2 (oral, vaginal, and transdermal) or other relevant outcome measures. No significant effect was observed for different daily doses of E2 (6, 4, and 2 mg), even through oral medication in CPR/PA.

Conclusion(s):
The best available evidence suggests that E2 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.

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