Effect of oral Utrogestan in comparison with Cetrotide on preventing luteinizing hormone surge in IVF cycles: A randomized controlled trial

Background: Oral progesterone is recommended as an alternative to gonadotropinreleasinghormone (GnRH) agonists and antagonists to prevent luteinizing hormone(LH) surge in assisted reproductive technology (ART) cycles. However, there are littledata regarding its use.Objective: We aimed to compare the effect of oral Utrogestan and Cetrotide (a GnRHantagonist) on preventing LH surge in ART cycles.Materials and Methods: In this randomized clinical trial, 100 infertile womenundergoing ART who received recombinant follicle-stimulating hormone (FSH) at 150-225 IU/day were randomly assigned to receive either Utrogestan 100 mg twice a day(case group) or GnRH antagonist protocol (control group) from cycle day 3 until thetrigger day. Triggering was performed with 10,000 IU hCG) when there were at leastthree mature follicles. Viable embryos were cryopreserved for transfer in the nextcycle for both groups. The number of oocytes retrieved and transferred embryos werecompared between groups.Results: The case group had significantly higher progesterone levels on triggering day,more follicles of > 14 mm with higher maturity, and more oocytes retrieved with a higherrate of embryos transferred. A small increase in the pregnancy rate was observed in thecase group, with no significant between-group differences. The most important resultwas the lack of premature LH surge in either group upon serum LH assessment on thetriggering day.Conclusion: Utrogestan is an alternative treatment that could reduce the LH surgerate and increase the ART outcomes including the number of oocytes retrieved andtransferred embryos compared with GnRH agonists and antagonists.

Keywords:

In vitro fertilization , Premature luteinization , Utrogestan