Luteal phase support in the intrauterine insemination [IUI] cycles: a randomized double blind, placebo controlled study

To evaluate the impact of luteal phase support with vaginal progesterone on pregnancy rates in the intrauterine insemination [IUI] cycles, stimulated with clomiphene citrate and human menopausal gonadotropin [hMG], in sub fertile couples. This prospective, randomized, double blind study was performed in a tertiary infertility center from March 2011 to January 2012. It consisted of 253 sub fertile couples undergoing ovarian stimulation for IUI cycles. They underwent ovarian stimulation with clomiphene citrate [100 mg] and hMG [75 IU] in preparation for the IUI cycle. Study group [n = 127] received luteal phase support in the form of vaginal progesterone [400 mg twice a day], and control group [n = 126] received placebo. Clinical pregnancy and abortion rates were assessed and compared between the two groups. The clinical pregnancy rate was not significantly higher for supported cycles than that for the unsupported ones [15.75% vs. 12.69%, p = 0.3]. The abortion rate in the patients with progesterone luteal support compared to placebo group was not statistically different [10% vs. 18.75%, p = 0.45]. It seems that luteal phase support with vaginal progesterone was not enhanced the success of IUI cycles outcomes, when clomiphene citrate and hMG were used for ovulation stimulation

Molar pregnancy presents as tubal ectopic pregnancy

Hydatidiform moles are abnormal gestations characterized by the presence of hydropic changes affecting some or all of the placental villi. Hydatidiform moles arise as a result of the fertilization of an abnormal ovum. In this report, the patient was a 29 year old Asian woman who had induction of ovulation with letrozol. Since the majority of molar gestations arise within the uterine cavity thus the occurrence of a hydatidiform mole within ectopic gestational tissue is rare. It is important to differentiate a hydatidiform mole from a conventional ectopic pregnancy, particularly in infertile women who have a history of ovulation induction

Luteal phase estradiol versus luteal phase GnRH antagonist administration: their effects on antral follicular size coordination and basal hormonal levels

The differential efficacy between long GnRH agonist with antagonist can partly be due to the preexisting differences in the early antral follicles before ovarian stimulation. To compare the effect of pretreatment by estradiol with GnRH antagonist on antral follicular size coordination and basal hormone levels in GNRH antagonist protocol. On cycle day 3 [control/day 3], women underwent measurements of early antral follicles by ultrasound and serum FSH and ovarian hormones then were randomized to receive oral estradiol 4mg/day [n=15] or 3mg cetrorelix acetate [n=15] in luteal phase before subsequent antagonist protocol. Participants were re-evaluated as on control/day 3. There was a significant reduction of mean follicular sizes in each group after medical intervention [7.63 +/- 2.11 Vs. 4.30 +/- 0.92 in group A and 8.73 +/- 1.96 Vs. 4.13 +/- 1.11 in group B] [p=0.0001]. The magnitude of follicular size reduction was significantly higher in group B [-4.60 +/- 2.04 Vs. -3.33 +/- 2.28] [0.027]. There was a non significant attenuation of follicular size discrepancies in two groups. FSH and inhibin B levels in the day 3 of the next cycle in both groups were significantly decreased but did not have significant difference between two groups. Both luteal E2 and premenstrual GnRH antagonist administration reduces the follicular sizes significantly and GnRH antagonist acts more potently than E2 in this way but attenuation of follicular size discrepancies in both treatment is not significant