Luteal phase support after mild ovulation induction with intrauterine insemination: an on-going debate

Abstract

Objective: To evaluate the effect of luteal phase support (LPS) using progesterone vaginal gel on pregnancy rate (PR) and live birth rate (LBR) during cycles in which controlled ovarian stimulation (COH) was performed using gonadotropins with intrauterine insemination (IUI) cycles in patients with unexplained infertility and polycystic ovarian syndrome.

Materials and methods: From 2010 to 2015, all IUI cycles in which COH was performed using gonadotropins were evaluated retrospectively. LPS was not used until July 2013, after which vaginal progesterone gel was applied in the luteal phase of IUI cycles. Both groups of patients were evaluated in terms of the effect of LPS on PR and LBR.

Results: In total, 1578 IUI cycles were evaluated, of which 481 were LPS (+) and 1097 LPS (−). PR and LBR per cycle were 10.6% and 7.4%, respectively, in the LPS (+) group, and 11.6% and 7.7%, respectively, in the LPS (−) group (p = 0.31 and p = 0.25). PR and LBR per patient were 17% and 12%, respectively, in the LPS (+) group, and 17.4% and 12.3%, respectively, in the LPS (−) group (p = 0.48 and p = 0.82).

Conclusions: We found no difference in PR and LBR per cycle and per patient according to the use of LPS in IUI cycles in which COH was performed using gonadotropins. Thus, routine use of LPS in gonadotropin-stimulated cycles requires further research involving larger numbers of patients.

Chinese abstract

目的：探讨不明原因的不育和多囊卵巢综合征患者在控制性促排卵(COH)的月经周期中使用促性腺激素进行宫内人工授精(IUI)后再使用黄体酮阴道凝胶进行的黄体支持（LPS)对患者妊娠率(PR)和活产率(LBR)的影响。

材料和方法：回顾性分析从2010年到2015年在COH条件下使用促性腺激素后所有处于IUI月经周期的患者。到2013年七月份后，对处于IUI月经黄体功能期使用阴道黄体酮凝胶后的患者研究LPS。探讨LPS对两组病人在PR和LBR方面的影响。

结果：探讨共处于IUI月经周期的患者1578例，其中481例LPS阳性，1097例LPS阴性。每个月经周期中PR为10.6%，LBR为7.4%，在LPS阳性组为11.6%，在LPS阴性组(p=0.31 and p=0.25)为7.7%。每个患者在PR和LBR分别为17%和12%，LPS阳性组17.4%，LPS阴性组(p=0.48 and p=0.82)12.3%。

结论：我们发现用促性腺激素后的每个IUI周期进行LPS对PR和LBR的影响没有明显差异。因此，促性腺激素刺激后的常规LPS仍需要大量患者的数据的研究。

• Gonadotrophins
• insemination
• luteal phase support
• pregnancy rate
• vaginal progesterone gel

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.