The beneficial effect of luteal phase support on pregnancy rates in women with unexplained infertility

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.