Objective

A major disadvantage of controlled ovarian hyperstimulation (COH) is that it may have a negative effect on the quality of the luteal phase. It is not clear if this negative effect extends to include IUI cycles. It is well known that the necessity of luteal phase support (LPS) during IVF-ET cycles. But it is not established the importance of LPS after COH/IUI. The aim of this study was to determine the impact of luteal phase support with daily vaginal progesterone on pregnancy outcomes undergoing COH/IUI.

Design

A retrospective study

Materials and Methods

This study included 2142 COH/IUI cycles from January 2012 to March 2015. Controlled ovarian hyperstimulation was conducted with Clomiphene citrate (100mg/day) and human menopausal gonadotropin. When sufficient follicular size and endometrial thickness had been reached, hCG was administrated and insemination was performed. According to LPS methods, we divided COH/IUI cycles into two groups.
Group A : daily vaginal progesterone support for 15 days [Crinone 8% gel 90mg (175 cycles)]
Group B : progesterone depot once [17-α-hydroxyprogesterone caproate 250 mg/IM (1967 cycles)]

Results

In each group, age (34.1±3.3 vs. 33.7±3.0) and other demographics did not show significant differences. Total pregnancy rate was 15.3% (327/2142) and ongoing pregnancy rate was 13.4% (287/2142). There were significant differences between group A and B in the pregnancy rate [20.0% (35/175) vs. 14.8% (292/1967), p=0.003] and ongoing pregnancy rate [18.9% (33/175) vs. 12.9% (254/1967), p=0.001].

Conclusions

It is well known that all stimulated IVF/ICSI cycles have a deficient luteal phase, therefore luteal phase support was emphasized. But in COH/IUI, the necessity of luteal phase support is controversial. This study showed higher pregnancy rates in daily progesterone support group and this result is considered due to adequate luteal phase support. We recommend daily luteal phase support for better pregnancy outcomes during COH/IUI.