Early progesterone cessation after in vitro fertilization/intracytoplasmic sperm injection: a randomized, controlled trial

Objective: To investigate the effect of stopping progesterone (P) support at week 5 versus week 8 on ongoing pregnancy rate after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Design: Prospective, randomized, controlled trial. Setting: University-affiliated infertility center. Patient(s): A total of 220 patients with intrauterine pregnancy demonstrated by transvaginal ultrasound after IVF/ICSI. Intervention(s): Luteal phase support with micronized vaginal P was suspended at week 5 or at week 8. Main Outcome Measure(s): Ongoing pregnancy rate, miscarriage rate, and number of bleeding episodes. Result(s): Progesterone levels were similar on the day of the first pregnancy ultrasound exam (149 +/- 108 vs. 167 +/- 115 ng/mL). Significantly more bleeding episodes were observed in the first trimester in the group with early cessation of P supplementation (18.0 +/- 2.6 vs. 7.2 +/- 1.3 episodes). Miscarriage rates among singleton pregnancies were similar in the two groups (5/80 vs. 6/79). Conclusion(s): Vaginal P supplementation after IVF/ICSI can be safely withdrawn at 5 weeks' gestation, because cycle outcome was similar to conventional luteal phase support up to 8 weeks of pregnancy. Clinical Trial Registration Number: NCT01177904. (Fertil Steril (R) 2012;98:858-62. (C) 2012 by American Society for Reproductive Medicine.)