The beneficial effect of luteal phase support on pregnancy rates in women with unexplained infertility

Abstract

The beneficial effect of luteal phase support on pregnancy rates in women with unexplained infertility J.H. Check 1,2 , J. Liss 2 , D. Check 2 1Cooper Medical School of Rowen University, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and infertility, Camden, NJ; 2Cooper Institute For Reproductive Hormonal Disorders, P.C. Marlton, NJ (USA) Summary Purpose: To determine what percentage of women with regular menses and unexplained infertility seem to develop a mature dominant follicle (18-24 mm average diameter and serum estradiol >200 pg/mL). Also to determine the efficacy of empirical progesterone (P) supplementation in the luteal phase for those with unexplained infertility who seem to make mature follicles. Materials and Methods: Serial ultrasounds and serum estradiol levels performed in cases of infertility over one year duration in patients with patent fallopian tubes, normal semen parameters, and normal post-coital test. Vaginal P of different types were given in the luteal phase as exclusive treatment. Results: A viable fetus past the first trimester was found in 71.7% of the 80% of women developing a mature follicle who were treated with P. Conclusions: For the combined effect of efficacy of therapy, cost, convenience, and lack of side effects, supplemental use of P in the luteal phase should be considered as first line therapy for unexplained infertility rather than empirical use of “fertility” drugs and intrauterine insemination or even in vitro fertilization - embryo transfer (IVF-ET). Methods of determining who needs supplemental P are not presently available. Key words: Unexplained infertility; Follicle maturation; Progesterone supplementation; Luteal phase.