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Meta-Analysis
. 2014 Jan;31(1):89-100.
doi: 10.1007/s10815-013-0127-6. Epub 2013 Nov 6.

Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis

Ester Miralpeix  1 , Mireia González-Comadran, Ivan Solà, Dolors Manau, Ramon Carreras, Miguel A Checa
Affiliations
Meta-Analysis

Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis

Ester Miralpeix et al. J Assist Reprod Genet. 2014 Jan.

Abstract

Purpose: To evaluate the efficacy of luteal phase support with vaginal progesterone in women undergoing intrauterine insemination (IUI).

Methods: Systematic review and meta-analysis. Randomized controlled trials (RCT) comparing supplementation of luteal phase with vaginal progesterone among women undergoing IUI versus a control group were included. The main outcome assessed was live birth rate.

Results: Five RCT met the inclusion criteria. In all 1,271 patients were included (951 IUI cycles in the progesterone group, 935 in the control group). Women treated with vaginal progesterone achieved significantly higher live birth rate (risk ratio [RR] 1.94, 95 % confidence interval [CI] 1.36 to 2.77,), and clinical pregnancy rate (RR 1.41, 95 % CI 1.14 to 1.76) as compared with controls. In the subgroup analysis per stimulation protocol, this beneficial effect of receiving progesterone was only observed in the group stimulated with gonadotropins (RR 2.28, 95 % CI 1.49 to 3.51), compared to the group stimulated with clomiphene citrate (CC) (RR 1.30, 95 % CI 0.68 to 2.50). No differences were observed in the miscarriage and multiple pregnancy rates.

Conclusions: The supplementation of luteal phase with vaginal progesterone significantly increases live birth among women undergoing IUI when receiving gonadotropins for ovulation induction. Women receiving CC to induce ovulation do not seem to benefit from this treatment.

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Figures

Fig. 1
Fig. 1
Flow chart for the trial identification and selection process
Fig. 2
Fig. 2
Efficacy of progesterone supplementation
Fig. 3
Fig. 3
Sensitivity analysis for live birth
Fig. 4
Fig. 4
Efficacy of progesterone supplementation
Fig. 5
Fig. 5
Results of progesterone supplementation in terms of adverse events
See this image and copyright information in PMC

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References

    1. Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA, et al. Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod. 2013;28:2318–31. - PubMed
    1. Fatemi HM, Popovic-Todorovic B, Papanikolaou E, Donoso P, Devroey P. An update of luteal phase support in stimulated IVF cycles. Hum Reprod Update. 2007;13:581–590. doi: 10.1093/humupd/dmm021. - DOI - PubMed
    1. Smitz J, Erard P, Camus M, Devroey P, Tournaye H, Wisanto A, et al. Pituitary gonadotropin secretory capacity during the luteal phase in superovulation using GnRH-agonists and HMG in a desensitization or flare-up protocol. Hum Reprod. 1992;7:1225–1229. doi: 10.1093/humrep/7.suppl_1.49. - DOI - PubMed
    1. Beckers NG, Macklon NS, Eijkemans MJ, Ludwig M, Felberbaum RE, Diedrich K, et al. Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment. J Clin Endocrinol Metab. 2003;88:4186–4192. doi: 10.1210/jc.2002-021953. - DOI - PubMed
    1. Tavaniotou A, Albano C, Smitz J, Devroey P. Comparison of LH concentrations in the early and mid-luteal phase in IVF cycles after treatment with HMG alone or in association with the GnRH antagonist Cetrorelix. Hum Reprod. 2001;16:663–667. doi: 10.1093/humrep/16.4.663. - DOI - PubMed