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Effect of luteal phase support with vaginal progesterone in intrauterine insemination cycles with regard to follicular response: a prospective randomized study.

OBJECTIVE
To investigate the effect of luteal phase support with vaginal progesterone on pregnancy rates of the gonadotropin-stimulated intrauterine insemination (IUI) cycles in patients with unexplained infertility with regard tofollicular growth.


STUDY DESIGN
A total of 149 patients with unexplained infertility who underwent 166 recombinant follicle stimulated hormone--stimulated IUI cycles were prospectively randomized into 2 groups for luteal phase support. The study group (n = 71) received vaginal progesterone gel supplementation, and the control group (n = 78) received no drug for luteal support. The clinical pregnancy rates and live birth rates per cycle and per patient were compared between the groups.


RESULTS
The differences between the groups with regard to clinical pregnancy rates and live birth rates per patient or per cycle were not different among all patients. In cycles with > 1 dominant follicle (multifollicular response), the clinical pregnancy rate per patient was significantly higher in the supported cycles as compared with the unsupported cycles (28.2% vs. 11.4%, respectively, p = 0.04). Reproductive outcomes in cycles with a single dominant follicle (monofollicular response) were not different between supported and unsupported cycles.


CONCLUSION
Luteal phase support with vaginal progesterone affects the success of gonadotropin-stimulated IUI cycles with multifollicular response but not with monofollicular response.