Evaluation of Necessity of Routine Luteal Phase Support After Ovarian Stimulation by Oral Ovulogen in Intrauterine Insemination Cycles

Objectives Assisted reproductive technology aims to achieve superovulation to receive optimum outcomes. Resulting supraphysiological estradiol levels cause luteal phase defect due to feedback inhibition of FSH and LH. During intrauterine insemination, this mechanism is seldom seen. Thus, routine use of progesterone in clinical practice adds to burden of medication and cost without much evidence to recommend it. The objective was to evaluate the clinical utility of luteal support with progesterone in IUI cycles stimulated by oral ovulogens. Material and methods A total of 200 women attending infertility OPD were randomly selected as per inclusion criteria (Unexplained infertility, Mild male factor, Donor sperm IUI, PCOD, Coital factors, Mild endometriosis) whereas those with factors like Age more than or equal to 38 years, thin endometrium, previous two or more IUI failures, history suggestive of luteal phase defect-short luteal phase, premenstrual spotting, premature rupture of follicles, presence of structural uterine anomaly, History of endocrine or autoimmune diseases were excluded from the study. After a baseline transvaginal examnination, they underwent ovarian stimulation from day 2 to day 6 by oral ovulogen, letrozole (2.5 mg) followed by Follicular study as per protocol and HCG trigger was given 10000 I.U s/c once dominant follicle develioped and IUI was timed at 36–44 hours after trigger only after confirmation of rupture on USG. Patients divided into two groups. Group A included those with absent luteal support and Group B to receive tab dydrogesterone. Conception, if any, reported by a positive urine pregnancy test kits or confirmed with serum Beta HCG is measured in mIU/ml. Results Among cases, 23% had a positive urine pregnancy test.Whereas, in controls 21% had a positive urine pregnancy test, the difference being statistically non-significant with p value = 0.733. Clinical pregnancy rate as a marker of successful outcome of study was present in 22%.Of cases and 21% of controls, although difference was statistically non-significant with p = 0.755. Conclusion Luteal phase support with progesterones makes no significant difference in clinical pregnancy rate oral ovulogen stimulated IUI cycles.