Does Progesterone Suppository to Luteal Phase Support Have Any Effect on Pregnancy Rates in the Intrauterine Insemination Cycles?

Document Type : Case Study

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

2 Yazd Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Objectives: Rate of infertility in overall is around 15-10%. Intra-Uterine Insemination (IUI) is one procedure for infertility treatment. Luteal phase support defect is a main factor in fail of pregnancy. Goal of this study was to evaluate the effect of luteal phase support with progesterone suppository in patients who undergoing IUI cycles.Materials & Methods: 100 infertile couples who were undergoing IUI treatment included in this study. Ovulation induction was done for all patients. When IUI was done, patients were distributed into two groups. The study group (n=50) received progesterone suppository and control group (n=50) doesn’t received any medicine. Then biochemical pregnancy rate, clinical pregnancy rate and abortion rate compared between two study groups. Results: There were no differences in basic characteristics between two groups. Biochemical and clinical pregnancy were parallel in the study and control groups. There were no statistically significant increases in abortion rate between the study groups (P=0.49). Conclusion: Luteal phase support by progesterone suppository does not improve the pregnancy rate of stimulated IUI cycles. 

Keywords


  1. Turchi P. Prevalence, definition, and classification of infertility. In: Cavallini G, Beretta G, editors. Clinical Management of Male Infertility. Frankfort: Springer; 2015.
  2. Cohlen B, Ombelet W. Intra-uterine insemination: evidence based guidelines for daily practice. Florida: CRC Press; 2013.
  3. Gildersleeve K, Haselton MG, Fales MR. Do women’s mate preferences change across the ovulatory cycle? A meta-analytic review. Psychological Bulletin. 2014; 140(5):1205–59. doi: 10.1037/a0035438
  4. Navarrete MAH, Maier CM, Falzoni R, Quadros LG de A, Lima GR, Baracat EC, et al. Assessment of the proliferative, apoptotic and cellular renovation indices of the human mammary epithelium during the follicular and luteal phases of the menstrual cycle. Breast Cancer Research. 2005; 7(3):306-13. doi: 10.1186/bcr994
  5. Romero Nieto MI, Lorente Gonzalez J, Arjona-Berral JE, del Muñoz-Villanueva M, Castelo-Branco C. Luteal phase support with progesterone in intrauterine insemination: a prospective randomized study. Gynecological Endocrinology. 2014; 30(3):197–201. doi: 10.3109/09513590.2013.859242
  6. Hossein Rashidi B, Davari Tanha F, Rahmanpour H, Ghazizadeh M. Luteal phase support in the intrauterine insemination (iui) cycles: A randomized double blind, placebo controlled study. Journal of Family & Reproductive Health. 2014; 8(4):149-53. PMCID: PMC4266785
  7. Li R, Yang S, Peng HY, Li Y, Zhou LY, Yuan L, et al. Intrauterine insemination treatment strategy for women over 35 years old: Based on a large sample multi-center retrospective analysis. Chinese Medical Journal. 2016; 129(23):2873. doi: 10.4103/0366-6999.194647
  8. Gopinath P, Desai R. Open-label observational study to determine the success rate of first cycle Intra Uterine Insemination (IUI) involving luteal phase support with oral natural or synthetic progesterone. International Journal of Medical Research & Health Sciences. 2014; 3(4):933. doi: 10.5958/2319-5886.2014.00028.9
  9. Miralpeix E, Gonzalez-Comadran M, Solà I, Manau D, Carreras R, Checa MA. Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis. Journal of Assisted Reproduction and Genetics. 2013; 31(1):89–100. doi: 10.1007/s10815-013-0127-6
  10. Chantilis SJ, Zeitoun KM, Patel SI, Johns DA, Madziar VA, McIntire DD. Use of Crinone vaginal progesterone gel for luteal support in in vitro fertilization cycles Crinone 8% (90 mg), Columbia Research Laboratories, Miami, Florida. Fertility and Sterility. 1999; 72(5):823–9. doi: 10.1016/s0015-0282(99)00362-3
  11. Fanchin R, Righini C, de Ziegler D, Olivennes F, Ledee N, Frydman R. Effects of vaginal progesterone administration on uterine contractility at the time of embryo transfer. Fertility and Sterility. 2001; 75(6):1136–40. doi: 10.1016/s0015-0282(01)01787-3
  12. Ebrahimi M, Akbari Asbagh F, Darvish S. The effect of luteal phase support on pregnancy rates of the stimulated intrauterine insemination cycles in couples with unexplained infertility. International Journal of Fertility and Sterility. 2010; 4(2):51-6.
  13. Costello MF, Emerson S, Lukic J, Sjoblom P, Garrett D, Hughes G, et al. Predictive value of mid luteal progesterone concentration before luteal support in controlled ovarian hyperstimulation with intrauterine insemination. The Australian and New Zealand Journal of Obstetrics and Gynaecology. 2004; 44(1):51–6. doi: 10.1111/j.1479-828x.2004.00160.x
  14. Montville CP, Khabbaz M, Aubuchon M, Williams DB, Thomas MA. Luteal support with intravaginal progesterone increases clinical pregnancy rates in women with polycystic ovary syndrome using letrozole for ovulation induction. Fertility and Sterility. 2010; 94(2):678–83. doi: 10.1016/j.fertnstert.2009.03.088
  15. Kyrou D, Fatemi HM, Tournaye H, Devroey P. Luteal phase support in normo-ovulatory women stimulated with clomiphene citrate for intrauterine insemination: Need or habit? Human Reproduction. 2010; 25(10):2501–6. doi: 10.1093/humrep/deq223
  16. Aali BS, Ebrahimipour S, Medhdizadeh S. The effectiveness of luteal phase support with cyclogest in ovarian stimulated intra uterine insemination cycles: A randomized controlled trial. Iranian Journal of Reproductive Medicine. 2013; 11(4):309–314. PMCID: PMC3941431
  17. Wen L, Chen LH, Li HY, Chang SP, Liao CY, Tsui KH, et al. Roles of estrogen and progesterone in endometrial hemodynamics and vascular endothelial growth factor production. Journal of the Chinese Medical Association. 2009; 72(4):188–93. doi: 10.1016/s1726-4901(09)70052-8
  18. Polyzos NP, Messini CI, Papanikolaou EG, Mauri D, Tzioras S, Badawy A, et al. Vaginal progesterone gel for luteal phase support in IVF/ICSI cycles: A meta-analysis. Fertility and Sterility. 2010; 94(6):2083–7. doi: 10.1016/j.fertnstert.2009.12.058
  19. Lockwood G, Griesinger G, Cometti B, de Placido G, Alviggi C, Ranieri A, et al. Subcutaneous progesterone versus vaginal progesterone gel for luteal phase support in in vitro fertilization: a noninferiority randomized controlled study. Fertility and Sterility. 2014; 101(1):112–9. doi: 10.1016/j.fertnstert.2013.09.010