Meta-analysis of estradiol for luteal phase support in in vitro fertilization intracytoplasmic sperm injection

This meta-analysis suggests that estradiol addition during the luteal phase does not improve in vitro fertilization/intracytoplasmic sperm injection outcomes through oral medication, even with different daily doses.

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Na Huang, M.S., Bing Situ, M.S., Xiao Chen, Ph.D., Jianqiao Liu, M.D., Pengke Yan, M.D., Ph.D., Xinhuang Kang, Ph.D., Songzhi Kong, Ph.D., Min Huang, Ph.D.

Volume 103, Issue 2, Pages 367-373



To evaluate whether the addition of E2 for luteal phase support (LPS) in IVF/intracytoplasmic sperm injection (ICSI) could improve the outcome of clinical pregnancy.




University hospital center.


Women underwent IVF or ICSI using the GnRH agonist or GnRH antagonist protocol.


Progesterone alone or combined with E2 for LPS.

Main Outcome Measure(s):

Clinical pregnancy rate per patient (CPR/PA), clinical pregnancy rate per ET, implantation rate, ongoing pregnancy rate per patient, clinical abortion rate, and ectopic pregnancy rate.


Fifteen relevant randomized controlled trials (RCTs) were identified that included a total of 2,406 patients. There was no statistical difference between E2 + P group and P-only group regarding the primary outcome of CPR/PA for different routes of administration of E2 (oral, vaginal, and transdermal) or other relevant outcome measures. No significant effect was observed for different daily doses of E2 (6, 4, and 2 mg), even through oral medication in CPR/PA.


The best available evidence suggests that E2 addition during the luteal phase does not improve IVF/ICSI outcomes through oral medication, even with different daily doses. Furthermore, RCTs that study other administration routes are needed.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.