Role of Low Dose Injectable Progesterone in Triggering Ovulation

Role of Low Dose Injectable Progesterone in Triggering Ovulation: A Randomized Controlled Trial

The aim of this study is to evaluate the role of low dose injectable progesterone in triggering ovulation.

Infertility affects approximately 10-15% of couples attempting pregnancy, with no readily identifiable cause found in 15-30% of these patients, resulting in a diagnosis of unexplained infertility.

Kol and Itskovitz-Eldor stated that when using GnRH agonist to trigger ovulation in IVF cycles, the LH surge is associated with a rapid rise of progesterone and the attainment of peak E2 levels through the first 12 h after GnRH agonist administration which is followed by a temporary suppression of progesterone biosynthesis and a gradual drop in E2 levels during the 24 h before follicle aspiration. After oocyte retrieval, a second rise in progesterone and continuous fall in E2 are noted, reflecting transitions from follicular to luteal phase in ovarian steroidogenesis.

Letrozole (LE) is a nonsteroidal, highly selective oral aromatase inhibitor (AI) that inhibits the synthesis of oestrogen and increases the secretion of endogenous gonadotropin by diminishing negative feedback to stimulate ovulation. Currently, letrozole is widely used as an adjunct for IVF cycles.

Inclusion Criteria:

• Age from 20 to 35 years.
• Infertile women.
• Basal follicle-stimulating hormone (FSH) level <10 mIU/ml.

Exclusion Criteria:

• Poor ovarian reserve.
• Immunological disease.
• Endometriosis.
• Uterine abnormality.
• Body mass index (BMI) >30 kg/m2.
• Endometrial thickness <8 or >12 mm on the day of triggering.