ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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ORİJİNAL ARAŞTIRMALAR

2016-2019 Yılları Arasında Kliniğimizde IUI Tedavisi Uygulanan Luteal Faz Desteği Alan ve Almayan Hastalarda Klinik Gebelik Sonuçlarının Karşılaştırılması
The Comparison of Clinical Pregnancy Results in Patients with and Without Luteal Phase Support in Iui Treatment in our Clinic Between 2016-2019
Received Date : 04 Dec 2020
Accepted Date : 08 Jan 2021
Available Online : 03 Feb 2021
Doi: 10.24074/tjrms.2020-80404 - Makale Dili: TR
TJRMS. 2020;4(1):8-14
ÖZET
Amaç: Intrauterin inseminasyon sikluslarında, basit olması ve düşük maliyeti nedeniyle sıklıkla tercih edilen progesteron ile luteal faz desteğinin klinik gebelik oranları üzerine etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışma, 2016 ve 2019 arasında kliniğimizde infertilite tanısı ile intrauterin inseminasyon yapılmış olan hastalar taranarak retrospektif olarak gerçekleştirildi. Vajinal progesteron desteği alan ve almayan hastalarda gebelik oranları karşılaştırıldı. Bulgular: Gebelik yakalama ve devam ettirme oranları açısından her iki grup karşılaştırıldığında progesteron destek tedavisi istatistiksel olarak anlamlı bulunmadı (p=0,644). Her iki grubun yaş ve bazal FSH değerleri arasında da anlamlı farklılık saptanmadı (p>0,05). Sonuç: Bu çalışmada intrauterin inseminasyon sikluslarında, luteal faz desteği amacıyla kullanılan vaginal progesteron desteğinin klinik gebelik sonuçlarını değiştirmediği görüldü.
ABSTRACT
Objective: It was aimed to investigate the effect of progesterone and luteal phase support, which is frequently preferred in intrauterine insemination cycles due to its simplicity and low cost, on clinical pregnancy rates. Materials and Methods: The study was conducted retrospectively by screening patients who underwent intrauterine insemination with a diagnosis of infertility in our clinic between 2016 and 2019. Pregnancy rates were compared in patients who received and did not receive vaginal progesterone support. Results: Progesterone supportive treatment was not statistically significant when the two groups were compared in terms of pregnancy occurrence and maintenance rates (p = 0.644). There was no significant difference between age and basal FSH values of both groups (p> 0.05). Conclusion: In this study, it was observed that vaginal progesterone support used for luteal phase support in intrauterine insemination cycles did not change the clinical pregnancy outcomes.
REFERANSLAR
  1. Abramowicz JS, Archer DF. Uterine endometrial peristalsis-a transvaginal ultrasound study. Fertility and Sterility. 1990;54(3):451-4.[Crossref] 
  2. Albano C, Felberbaum R, Smitz J, Riethmuller-Winzen H, Engel J, Diedrich K, et al. Ovarian stimulation with HMG: results of a prospective randomized phase III European study comparing the luteinizing hormone-releasing hormone (LHRH)-antagonist cetrorelix and the LHRH-agonist buserelin. Human Reproduction. 2000;15(3):526-31.[Crossref] [PubMed] 
  3. Albuquerque L, Saconato H, Maciel M, Baracat E, Freitas V. Depot versus daily administration of GnRH agonist protocols for pituitary desensitization in assisted reproduction cycles: a Cochrane Review. Human Reproduction. 2003;18(10):2008-17.[Crossref] [PubMed] 
  4. Barbosa M, Silva L, Navarro P, Ferriani R, Nastri C, Martins W. Dydrogesterone vs progesterone for luteal‐phase support: systematic review and meta‐analysis of randomized controlled trials. Ultrasound in Obstetrics & Gynecology. 2016;48(2):161-70.[Crossref] [PubMed] 
  5. Barlow D. GnRH agonists and in vitro fertilization. The Journal of reproductive medicine. 1998;43(3 Suppl):245-51.
  6. Benadiva CA, Metzger DA. Superovulation with human menopausal gonadotropins is associated with endometrial gland-stroma dyssynchrony. Fertility and sterility. 1994;61(4):700-4.[Crossref] 
  7. Tavaniotou A, Smitz J, Bourgain C, Devroey P. Comparison between different routes of progesterone administration as luteal phase support in infertility treatments. Human Reproduction Update. 2000;6(2):139-48.[Crossref] [PubMed] 
  8. Penzias AS. Luteal phase support. Fertility and sterility. 2002;77(2):318-23.[Crossref] 
  9. Işıkalan M, Ürünsak İF, Khatib G, Çetin C, Sucu M, Çetin T. Intrasitoplazmik sperm enjeksiyonu sikluslarında luteal faz desteğinde intramusküler ve vajinal progesteron kullanımının gebelik oranlarına etkisinin karşılaştırılması. Cukurova Medical Journal. 2016;41(4):639-47.[Crossref] 
  10. Bourgain C, Devroey P, Waeshberghe LV, Smitz J, Steirteghem AV. Effects of natural progesterone on the morphology of the endometrium in patients with primary ovarian failure. Human Reproduction. 1990;5(5):537-43.[Crossref] [PubMed] 
  11. Fritz M, Speroff L. Klinik Jinekolojik Endokrinoloji ve İnfertilite. Güneş Tıp Kitabevleri. 2014;8.
  12. Keenan JA, Moghissi KS. Luteal phase support with hCG does not improve fecundity rate in human menopausal gonadotropin-stimulated cycles. Obstetrics and gynecology. 1992;79(6):983-7.
  13. Hamilton CJ, Jaroudi KA, Sieck UV. The value of luteal support with progesterone in gonadotropin-induced cycles. Fertility and sterility. 1993;60(5):786-90.[Crossref] 
  14. Hill MJ, Whitcomb BW, Lewis TD, Wu M, Terry N, DeCherney AH, et al. Progesterone luteal support after ovulation induction and intrauterine insemination: a systematic review and meta-analysis. Fertility and sterility. 2013;100(5):1373-80. e6.[Crossref] [PubMed] 
  15. Peeraer K, D'Hooghe T, Laurent P, Pelckmans S, Delvigne A, Laenen A, et al. Impact of luteal phase support with vaginal progesterone on the clinical pregnancy rate in intrauterine insemination cycles stimulated with gonadotropins: a randomized multicenter study. Fertility and sterility. 2016;106(6):1490-5.[Crossref] [PubMed] 
  16. Bakay K, Aytekin F, Celik NY. Progesterone Supplement and Luteal Phase Deficiency in Unifollicular Intrauterine Insemination Cycles. 2015.[Crossref] 
  17. Levine H. Luteal support in IVF using the novel vaginal progesterone gel Crinone 8%: results of an open-label trial in 1184 women from 16 US centers. Fertility and sterility. 2000;74(4):836-7.[Crossref] 
  18. Ganesh A, Chakravorty N, Mukherjee R, Goswami S, Chaudhury K, Chakravarty B. Comparison of oral dydrogestrone with progesterone gel and micronized progesterone for luteal support in 1,373 women undergoing in vitro fertilization: a randomized clinical study. Fertility and sterility. 2011;95(6):1961-5.[Crossref] [PubMed] 
  19. Patki A, Pawar VC. Modulating fertility outcome in assisted reproductive technologies by the use of dydrogesterone. Gynecological Endocrinology. 2007;23(sup1):68-72.[Crossref] [PubMed] 
  20. Chakravarty BN, Shirazee HH, Dam P, Goswami SK, Chatterjee R, Ghosh S. Oral dydrogesterone versus intravaginal micronised progesterone as luteal phase support in assisted reproductive technology (ART) cycles: results of a randomised study. The Journal of steroid biochemistry and molecular biology. 2005;97(5):416-20.[Crossref] [PubMed] 
  21. Green KA, Zolton JR, Schermerhorn SM, Lewis TD, Healy MW, Terry N, et al. Progesterone luteal support after ovulation induction and intrauterine insemination: an updated systematic review and meta-analysis. Fertility and Sterility. 2017;107(4):924-33. e5.[Crossref] [PubMed] 
  22. Pekcan MK, Özakşit G. Gonadotropin ile oluşturulan kontrollü ovaryan stimulasyon-intrauterin inseminasyon sikluslarında kullanılan progesteron formunun ve tedavi etkinliğinin karşılaştırılması. Ege Tıp Dergisi. 2019;58(1):74-7.
  23. DEMİREL C, ENGİN Y, ÜSTÜN Y, AYDOS K, ÜNLÜ C. Erkek faktörüne bağlı infertilitede intrauterin inseminasyon başarısına etki edecek faktörlerin analizi. Journal of Clinical Obstetrics & Gynecology. 2002;12(1):78-82.
  24. Shenfield F, Doyle P, Valentine A, Steele S, Tan S-L. Effects of age, gravidity and male infertility status on cumulative conception rates following artificial insemination with cryopreserved donor semen: analysis of 2998 cycles of treatment in one centre over 10 years. Human Reproduction. 1993;8(1):60-4.[Crossref] [PubMed]