International Journal of
Reproductive Biomedicine
Sat, Jan 18, 2025
[Archive]
Volume 11, Issue 4 (6-2013)
IJRM 2013, 11(4): 309-0 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Aali B S, Ebrahimipour S, Medhdizadeh S. The effectiveness of luteal phase support with cyclogest in ovarian stimulated intra uterine insemination cycles: A randomized controlled trial. IJRM 2013; 11 (4) :309-0
URL: http://ijrm.ir/article-1-410-en.html
URL: http://ijrm.ir/article-1-410-en.html
1- Physiology Research Center, Department of Obstetrics and Gynecology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran , shahnaz.aali@gmail.com
2- Department of Obstetrics and Gynecology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
3- Dentistry School, Kerman University of Medical Sciences, Kerman, Iran
2- Department of Obstetrics and Gynecology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
3- Dentistry School, Kerman University of Medical Sciences, Kerman, Iran
Abstract: (4033 Views)
Background: Controlled ovarian stimulation combined with intra uterine insemination (IUI) is a convenient treatment of infertility with a success rate of 11%. The clinical observation and pattern of progesterone secretion in this method is suggestive of luteal phase defect and postulated as an implicating factor of treatment failure.
Objective: To investigate the efficacy of luteal phase support with intravaginal cyclogest in women undergoing controlled ovarian stimulation combined with intrauterine insemination.
Materials and Methods: In this single-blinded clinical trial, 196 consecutively seen women eligible for the study protocol, were randomized to receive either intravaginal progesterone (cyclogest pessary, Actavis) or no medication in luteal phase. Blood samples were collected and serum progesterone level in 7th and 11th day of the cycle, biochemical and clinical pregnancy and luteal phase duration were compared in case and control groups.
Results: The mean age in case and control group was 28 and 27.9 years, respectively and the most frequent cause of infertility was unexplained. Additionally, ovulatory dysfunction was the most common cause of female infertility in both groups. Based on these variables, there was no statistically significant difference between the two groups. Mean serum progesterone level in the case group were 48.34 and 34.24nmol/day on day 7 and 11 after insemination, respectively and both values were significantly higher than the control group. There was no difference between the two groups in terms of biochemical and clinical pregnancy. Luteal phase duration in the case group was significantly longer than the control group.
Conclusion: Luteal phase support by Cyclogest pessary increases progesterone level and prolongs the luteal phase, but does not affect success rate of IUI cycles in terms of achieving pregnancy.
Objective: To investigate the efficacy of luteal phase support with intravaginal cyclogest in women undergoing controlled ovarian stimulation combined with intrauterine insemination.
Materials and Methods: In this single-blinded clinical trial, 196 consecutively seen women eligible for the study protocol, were randomized to receive either intravaginal progesterone (cyclogest pessary, Actavis) or no medication in luteal phase. Blood samples were collected and serum progesterone level in 7th and 11th day of the cycle, biochemical and clinical pregnancy and luteal phase duration were compared in case and control groups.
Results: The mean age in case and control group was 28 and 27.9 years, respectively and the most frequent cause of infertility was unexplained. Additionally, ovulatory dysfunction was the most common cause of female infertility in both groups. Based on these variables, there was no statistically significant difference between the two groups. Mean serum progesterone level in the case group were 48.34 and 34.24nmol/day on day 7 and 11 after insemination, respectively and both values were significantly higher than the control group. There was no difference between the two groups in terms of biochemical and clinical pregnancy. Luteal phase duration in the case group was significantly longer than the control group.
Conclusion: Luteal phase support by Cyclogest pessary increases progesterone level and prolongs the luteal phase, but does not affect success rate of IUI cycles in terms of achieving pregnancy.
Type of Study: Original Article |
References
1. Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AMA. WHO Manual for the Standardized Investigation, Diagnosis and Management of the Infertile Male. 1st Ed. Cambridge, UK, Cambridge University Press ; 2000:5-6.
2. Ryan KJ, Berkowitz RS, Barbieri RL, Dunai FA. Kistner's Gynecology and Women's Health. 7th Ed. St Louis: Mosby; 1999: 327-530.
3. Berek J, novak E. Berek & Novak's gynecology: Lippincott Williams & Wilkins 2007: 1138-1185.
4. Fritz M, Speroff L. Sperm and egg transport, fertilization, and implantation. Clinical gynecologic endocrinology and infertility. 8th Ed. Philadelphia: Lippicott Williams & Wilkinsa 2011: 243-268.
5. Gregoriou O, Vitoratos N, Papadias C. Pregnancy rates in gonadotrophin stimulated cycles with timed intercourse of intrauterine insemination for the treatment of male sub fertility. Eur J Obstet Gynecol Reprod Biol 1996; 64: 213-216. [DOI:10.1016/0301-2115(95)02280-5]
6. Cohlen BJ. Should luteal phase support be introduced in ovarian stimulation/IUI programmes? An evidence-based review. Reprod Biomed Online 2009; 19 (Suppl.): 4239.
7. Akbari S, Ayazi Roozbahani M, Ayazi Roozbahani F. Comparing of letrozole versus clomiphene citrate combined with gonadotropins in intrauterine insemination cycles. Iran J Reprod Med 2012; 10: 29-32.
8. Gardner DK, Weissman A, Howles CM, Shoham Z. Text Book of Assisted Reproductive Techniques. 2nd Ed. London and New York, Taylor and Francis 2004: 439-450.
9. Al-Ramahi M, Perkins S, Claman P. Serum progesterone in predicting pregnancy outcome after assisted reproductive technology. J Assist Reprod Genet 1999; 16: 117-120. [DOI:10.1023/A:1022523613267]
10. Tummaruk P, Tienthai P, Manee-In S, Srisuwatanasagul S. Expression of progesterone receptor in the utero-tubal junction after intra-uterine and deep intra-uterine insemination in sows. Anim 2010; 45: e26-31.
11. Erdem A, Erdem M, Atmaca S, Guler I. Impact of luteal phase support on pregnancy rates in intrauterine insemination cycles: a prospective randomized study. Fertil Steril 2009; 91: 2508-2513. [DOI:10.1016/j.fertnstert.2008.04.029]
12. Montville CP, Khabbaz M. Luteal support with intravaginal progesterone increases clinical pregnancy rates in women with polycystic ovary syndrome using letrozole for ovulation induction. Fertil Steril 2010; 94: 678-683. [DOI:10.1016/j.fertnstert.2009.03.088]
13. Ebrahimy 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. 12th International Congress of Gynecology and Obstetrics 2010.
14. Mehrafza M, Nobakhti N, Atrkar Roushan A, Dashtdar H, Oudi M, Hosseini A. The Correlation Between Semen Parameters and Pregnancy Outcome after Intrauterine Insemination. Iran J Reprod Med 2003; 1: 29-32.
15. Kyrou D,Fatemi HM, Tournaye H, Devroey P. Luteal phase support in normoovulatorywomen stimulated withclomiphene citrate for intrauterineinsemination: need or habit? Hum Reprod 2010; 25: 2501-2506.
16. 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. Aust N Z J Obstet Gynaecol 2004; 44: 51-56. [DOI:10.1111/j.1479-828X.2004.00160.x]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
