Progesterone luteal support after ovulation induction and intrauterine insemination a systematic review and meta analysis

Progesterone for luteal support after ovulation induction IUI was associated with increased likelihood of pregnancy and live birth in gonadotropin cycles but not in clomiphene citrate (CC) cycles.

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Authors

Micah J. Hill, D.O., Brian W. Whitcomb, Ph.D., Terrence D. Lewis, M.D., Mae Wu, D.O., Nancy Terry, Alan H. DeCherney, M.D., Eric D. Levens, M.D., Anthony M. Propst, M.D.

Volume 100, Issue 5, Pages 1373-1380.e6, November 2013

Abstract

Objective:

To evaluate the effect of luteal phase P support after ovulation induction IUI.

Design:

A systematic review and meta-analysis.

Setting:

Not applicable.

Patient(s):

Undergoing ovulation induction IUI.

Intervention(s):

Any form of exogenous P in ovulation induction IUI cycles.

Main Outcome Measure(s):

Clinical pregnancy and live birth.

Result(s):

Five trials were identified that met inclusion criteria and comprised 1,298 patients undergoing 1,938 cycles. Clinical pregnancy (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.15–1.98) and live birth (OR 2.11, 95% CI 1.21–3.67) were more likely in P-supplemented patients. These findings persisted in analyses evaluating per IUI cycle, per patient, and first cycle only data. In subgroup analysis, patients receiving gonadotropins for ovulation induction had the most increase in clinical pregnancy with P support (OR 1.77, 95% CI 1.20–2.6). Conversely, patients receiving clomiphene citrate (CC) for ovulation induction showed no difference in clinical pregnancy with P support (OR 0.89, 95% CI 0.47–1.67).

Conclusion(s):

Progesterone luteal phase support may be of benefit to patients undergoing ovulation induction with gonadotropins in IUI cycles. Progesterone support did not benefit patients undergoing ovulation induction with CC, suggesting a potential difference in endogenous luteal phase function depending on the method of ovulation induction.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)00734-6/fulltext


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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. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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