IMR Press / CEOG / Volume 46 / Issue 3 / DOI: 10.12891/ceog4697.2019
Open Access Original Research
The beneficial effect of luteal phase support on pregnancy rates in women with unexplained infertility
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1 Cooper Medical School of Rowen University, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and infertility, Camden, NJ, USA
2 Cooper Institute For Reproductive Hormonal Disorders, P.C. Marlton, NJ, USA
Clin. Exp. Obstet. Gynecol. 2019 , 46(3), 447–449; https://doi.org/10.12891/ceog4697.2019
Published: 10 June 2019
Abstract

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.

Keywords
Unexplained infertility
Follicle maturation
Progesterone supplementation
Luteal phase
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