Luteal Phase Progesterone Supplementation in ICSI Cycles: What is the Best Timing?

Objective: To study the effect of time of start of luteal phase support on pregnancy rate and implantation rate following ICSI cycle. Design: Randomized controlled trial. Setting: Benha IVF center and private unit. Participants and Interventions: Women undergoing IVF/ ICSI programs were randomized on day of OPU to receive progesterone supplementation either on day of OPU or on day of Embryo transfer. Outcome Measures: Clinical pregnancy rate was the primary outcome, implantation rate and serum progesterone were secondary outcomes. Results: There was no significant difference in pregnancy rate or implantation rate between both groups. Serum progesterone level measured at OR day group in group 1 was lower than that of group 2 (8.43±1.77ng/ml) and (9.49±1.89ng/ml) but the difference between the two groups was not significant. After 48 hours of progesterone administration we found a dramatic change in progesterone levels in both groups, since group 1 had a statistically significant higher levels (20± 12.92ng/ml) than group 2 (14.51±6.72ng/ml). Conclusion: Timing of progesterone administration either at the oocyte retrieval or at embryo transfer gave a good pregnancy rate with no significant difference between the two groups.