Çiğdem AKCABAY, İbrahim ÜRÜNSAK, Ümran KÜÇÜKGÖZ GÜLEÇ, Esra CİHAN, Mete SUCU, Yılmaz ATAY

Agonist IVF-ICSI-ET sikluslarında luteal faz desteği için verilen östradiol’ün gebelik oranlarına etkisi

Amaç: Bu çalışmanın amacı agonist in-vitro fertilizasyon (IVF) / intrasitoplazmik sperm enjeksiyonu (ICSI) / embriyo transferi (ET) siklüslerinde, luteal faz desteği için progesterona ek olarak estrojen vermenin gebelik oranları üzerine etkisinin araştırılmasıdır. Gereç ve Yöntem: Bu çalışmaya toplamda IVF / ICSI endikasyonu olan 142 hasta çalışmaya alındı. Hastalar, oosit toplama işleminden (OPU) sonra luteal destek için progesteron (kontrol grubu n = 71) ve ek olarak transdermal östrojen (çalışma grubu n = 71) verilmek üzere randomize edildi. Östrojen seviyeleri, embriyonun transfer gününde ve transfer sonrası 12. günde ölçüldü. Çalışmanın esas sonucu devam eden gebelik oranıdır. Her iki grup indüksiyon özellikleri, östrojen seviyeleri, β-hCG pozitifliği ve düşük oranları açısından da karşılaştırıldı. Bulgular: Gruplar arasında yaş, infertilite süresi ve endikasyon açısından istatistiksel olarak anlamlı fark yoktu. Her iki grup indüksiyon özellikleri ve E2 düzeyleri açısından benzerdi. β-hCG pozitiflik oranı benzerdi ve devam eden gebelik oranı her iki grupta benzerdi. Biyokimyasal ve klinik abortus oranları açısından da her iki grup arasında anlamlı fark yoktu. 12. gün östrojen seviyesi gebelik elde edilen hastalarda, elde edilemeyenlere göre anlamlı düzeyde yüksekti. Sonuç: Çalışmamız; luteal destek amacı ile progesterona ek olarak östrojen eklenmesinin β-hCG pozitifliği, devam eden gebelik ve düşük oranları üzerinde olumlu bir etkisi olmadığını göstermiştir.

The effect of estradiol on pregnancy rates for luteal phase support in IVF-ICSI-ET agonist cycles

Purpose: The aim of this study was to investigate the effect of transdermal estrogen on pregnancy rates in addition to progesterone for luteal phase support in agonist in-vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) / embriyo transfer (ET) cycles. Material and Methods: This randomized controlled study (RCT) enrolled a total of 142 patients with an indication for IVF/ICSI. We randomized patients prospectively to administer either progesterone (control group n=71) and additionally transdermal estrogen patch (study group n=71) as luteal support after oocyte retrieval. The levels of estrogen was determined on the day of transfer of embryo and 12th day. The main outcome measure was the ongoing pregnancy rate. Both groups were also compared for the induction characteristics, estrogen levels, β-hCG positivity, and abortion rates. Results: There were no significant differences between the groups according to age, infertility time, and indications. Both groups were similar for induction characteristics and E2 levels. β-hCG positivity rate was similar and the ongoing pregnancy rate was similar in both groups. Biochemical and clinical abortion rates were also similar in both groups. On the 12th day, estrogen levels increased significantly in those who became pregnant group. Conclusion: Our study showed that adding supplementary estrogen to the progesterone has no positive effect on β-hCG positivity, ongoing pregnancy, and abortion rates.

Keywords:

IVF-ICSI-ET Cycles, GnRH analogues, luteal phase support, progesterone, estrogen.,

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