Use of Utrogestan during controlled ovarian hyperstimulation in normally ovulating women undergoing in vitro fertilization or intracytoplasmic sperm injection treatments in combination with a "freeze all" strategy: a randomized controlled dose-finding study of 100 mg versus 200 mg

Abstract

Objective: To compare the clinical characteristics in a Utrogestan and hMG protocol with the use of different doses of Utrogestan in normally ovulating women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments.

Design: Prospective controlled study.

Setting: Tertiary-care academic medical center.

Patient(s): A total of 150 infertile patients undergoing IVF/ICSI treatments.

Intervention(s): Utrogestan and hMG were administered simultaneously beginning on cycle day 3. The dose of Utrogestan was 100 mg/d in the study group and 200 mg/d in the control group. When the dominant follicles reached mature, 0.1 mg GnRH agonist was used for trigger. Viable embryos were cryopreserved in both protocols for later transfer.

Main outcome measure(s): The primary outcome measure was the incidence of premature LH surge. Secondary outcomes included the embryo results and clinical pregnancy outcomes.

Result(s): Consistent LH suppression was achieved during controlled ovarian hyperstimulation with Utrogestan at 100 mg, and the number of patients with profound LH suppression (LH <1.2 IU/L) in the low-dose group was significantly less than that in the high-dose group. The number of oocytes retrieved in the low-dose group was similar to that in the high-dose group (9.87 ± 5.77 vs. 10.25 ± 5.43). No significant differences were observed in the number of mature oocytes, viable embryos, clinical pregnancy rate, or implantation rate.

Conclusion(s): Utrogestan at 100 mg is as effective as Utrogestan at 200 mg in reducing premature LH surge during controlled ovarian hyperstimulation.

Clinical trial registration number: ChiCTR-OOC-14005277.

Keywords: Utrogestan; controlled ovarian hyperstimulation; dose; frozen-thawed embryo transfer; premature LH surge.