Early progesterone cessation after in vitro fertilization intracytoplasmic sperm injection A randomized, controlled trial

Capsule:
Luteal phase supplementation with vaginal progesterone after in vitro fertilization/intracytoplasmic sperm injection can be safely withdrawn at 5 weeks’ gestation.

Authors:
Graciela Kohls, M.D., Francisco Ruiz, M.D., María Martínez, M.D., Erik Hauzman, M.D., Gabriel de la Fuente, M.D., Antonio Pellicer, M.D., Juan A Garcia-Velasco, M.D.

Volume 98, Issue 4, Pages 858-862, October 2012

Abstract:

Objective:
To investigate the effect of stopping progesterone (P) support at week 5 versus week 8 on ongoing pregnancy rate after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

Design:
Prospective, randomized, controlled trial.

Setting:
University-affiliated infertility center.

Patients:
A total of 220 patients with intrauterine pregnancy demonstrated by transvaginal ultrasound after IVF/ICSI.

Interventions:
Luteal phase support with micronized vaginal progesterone was suspended at week 5 or ar week 8.

Main Outcome Measures:
Ongoing pregnancy rate, miscarriage rate, and number of bleeding episodes.

Results:
Progesterone levels were similar on the day of the first pregnancy ultrasound exam (149 ± 108 vs. 167 ± 115 ng/mL). Significantly more bleeding episodes were observed in the first trimester in the group with early cessation of P supplementation (18.0 ± 2.6 vs. 7.2 ± 1.3 episodes). Miscarriage rates among singleton pregnancies were similar in the two groups (5/80 vs. 6/79).

Conclusions:
Vaginal P supplementation after IVF/ICSI can be safely withdrawn at 5 weeks’ gestation, because cycle outcome was similar to conventional luteal phase support up to 8 weeks of pregnancy.

Clinical Trial Registration Number:
NCT01177904.

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