Abstract
Background: Luteal phase defects, characterized by inadequate progesterone secretion and insufficient secretory transformation of the endometrium, are common among infertile women, occurring in approximately 50% of anovulatory patients and 60% of women with recurrent pregnancy loss. These defects may negatively affect implantation and early pregnancy outcomes.
Objective: To evaluate the outcomes of intracytoplasmic sperm injection (ICSI) in infertile women with mild and marked luteal defective cycles (LDC) following embryo transfer.
Patients and Methods: Women diagnosed with mild or marked LDC underwent controlled ovarian stimulation, oocyte retrieval, ICSI, and embryo transfer. Follicular fluid levels of progesterone, estradiol, and testosterone were measured. Clinical outcomes—including ICSI success rate, embryo transfer rate, pregnancy rate, and cycle cancellation rate—were compared between groups.
Results: Follicular fluid estradiol and progesterone concentrations were significantly higher in the mild LDC group, whereas prolactin and testosterone levels were significantly elevated in the marked LDC group. No significant differences were observed in FSH or LH levels. The ICSI success rate was 74.4% in mild LDC and 70.7% in marked LDC. Embryo transfer was significantly more frequent in mild LDC (85.2%) compared with marked LDC (50%, P < 0.001). Pregnancy rates per embryo transfer were 38% in mild LDC and 30.3% in marked LDC. Cycle cancellation occurred in 4% of mild LDC cases and 13% of marked LDC cases.
Conclusions: ICSI combined with luteal support therapy enhances embryo implantation and pregnancy outcomes in infertile women with both mild and marked luteal defective cycles. This approach is also beneficial in cases involving severe teratozoospermia or poor sperm penetration.