A luteal estradiol protocol for expected poor-responders improves embryo number and quality

Objective: To compare embryo and oocyte data between a standard protocol and a luteal phase estradiol protocol. Design: Retrospective paired cohort analysis. Setting: Private in vitro fertilization (IVF) center. Patient(s): 60 poor-responder patients undergoing 120 IVF cycles. Intervention(s): Addition of luteal estradiol to the standard IVF protocol. Main Outcome Measure(s): Number of embryos with >= 7 cells on day 3 of development. Result(S): The luteal phase estradiol protocol showed a statistically significantly greater number of embryos with >= 7 cells, oocytes retrieved, mature oocytes, and embryos than did the standard protocol. There was no difference between the two protocols with respect to basal antral follicle count, days of stimulation, number of follicles >= 14 mm on day of surge, or endometrial thickness on day of surge. A trend toward improved pregnancy outcomes was found with the luteal estradiol protocol. Conclusion(s): Giving estradiol in the luteal phase preceding IVF hyperstimulation increases the number and the quality of embryos achieved in patients deemed to have a poor response to WE Ultimately, this may translate into improved pregnancy outcomes in these patients.