Effects of luteal estradiol pre-treatment on the outcome of IVF in poor ovarian responders

Abstract

Background: In view of the discrepancies about the luteal estradiol treatment before stimulation protocols having some potential advantages compared with the standard protocols in poor ovarian responders undergoing IVF, a meta-analysis of the published data was performed to compare the efficacy of the luteal estradiol pre-treatment protocols in IVF poor response patients. Methods: We searched for all published articles. The searches yielded 32 articles, from which seven studies met the inclusion criteria. We performed this meta-analysis involving 450 IVF patients in luteal estradiol pre-treatment protocol group and 606 patients in standard protocol group. Results: The luteal estradiol protocol resulted in a significantly higher duration of stimulation compared with the standard protocol. In addition, the number of oocytes retrieved and mature oocytes retrieved were significantly higher in the luteal estradiol protocols than those in the standard protocols. The cycle cancellation rate (CCR) in the luteal estradiol protocols was lower than the standard protocols. Moreover, no significant difference was found in the clinical pregnancy rate (CPR). Conclusions: The addition of the estradiol in the luteal phase preceding IVF in poor responders improved IVF cycle outcomes, including increasing the number of oocytes retrieved and mature oocytes retrieved and decreasing the CCR.

Keywords::

• in vitro fertilization
• luteal estradiol treatment
• ovarian stimulation
• poor responder

Acknowledgements

The authors wish to express their sincere gratitude to all investigators who have actively participated in this study: Department of Obstetrics & Gynecology, The First Affiliated Hospital of Nanjing Medical University (study design, investigation and data collection): DanhuaPu, Lin li, WeiqingNing, Jing Liu.

Declaration of Interest: This study was not supported by funding. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.