A luteal estradiol protocol for anticipated poor-responder patients may improve delivery rates

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• 作者：Micah J. Hill ; Grant D.E. McWilliams ; Kathleen A. Miller ; Richard T. Scott Jr. ; John L. Frattarelli
• 关键词：Poor responders ; IVF outcome ; luteal phase ; estradiol ; embryo morphology ; oocytes ; pregnancy ; microdose flare ; GnRH antagonist
• 刊名：Fertility and Sterility
• 出版年：2009
• 出版时间：March 2009
• 年：2009
• 卷：91
• 期：3
• 页码：739-743
• 全文大小：110 K

文摘

Objective

To compare IVF data and outcomes between a standard protocol and a luteal phase E₂ protocol.

Design

Retrospective cohort analysis.

Setting(s)

Large academic assisted reproduction technologies center.

Patient(s)

Fifty-seven infertile patients with a history of poor response to IVF stimulation and 228 matched control patients.

Intervention(s)

IVF with a standard protocol or a luteal phase E₂ protocol.

Main Outcome Measure(s)

Live-birth rates.

Result(s)

Patients in the luteal E₂ protocol required more days of stimulation and total gonadotropins and had higher peak E₂ levels when compared with the control group. The luteal E₂ protocol showed a greater percentage of embryos with ≥7 cells on day 3. A trend toward improved delivery rates was seen in the luteal E₂ protocol (28.1 % vs. 22.4 % ; relative risk, 1.25, 0.78–2.03).

Conclusion(s)

A luteal E₂ protocol results in improved day 3 embryo development as demonstrated by the percent of embryos at the ≥7-cell stage. Likewise, the luteal E₂ protocol may ultimately improve pregnancy outcomes for patients with poor response to IVF stimulation.