Short Versus Extended Progesterone Supplementation for Luteal Phase Support in fresh IVF cycles: a systematic review and meta-analysis

Publication date: Available online 24 October 2019Source: Reproductive BioMedicine OnlineAuthor(s): M Watters, M Noble, T Child, SM NelsonAbstractThis review and meta-analysis aims to assess the effect of prolonged progesterone support on pregnancy outcomes in women undergoing a fresh embryo transfer after IVF/ICSI.Two independent reviewers searched EMBASE, MEDLINE and grey literature from inception to January 2019 for RCTs of prolonged progesterone support vs early cessation. Risk of bias was assessed. Outcome measures were live birth, miscarriage and ongoing pregnancy rate. Study protocol CRD42018088605.Seven trials involving 1,627 participants were included: 3 reported live birth rate with 672 livebirths in 830 participants, 7 the miscarriage rate with 178 miscarriages in 1,627 participants and 7 the ongoing pregnancy with 1,351 ongoing pregnancies in 1,627 participants. Clinical outcomes were similar between early progesterone cessation vs progesterone continuation: live birth rate (RR: 0.94, 95% CI: 0.84-1.00), miscarriage rate (RR: 0.91, 95% CI: 0.69-1.20), ongoing pregnancy rate (RR: 0.98, 95% CI:0.91-1.05). Ongoing pregnancy rates were similar when we restricted analyses to those with randomization on the day of a positive hCG (RR: 0.93, 95% CI 0.83, 1.06).This meta-analysis suggests that prolonged progesterone support may be unnecessary after fresh embryo transfer. Further larger RCTs would be useful to corroborate and lead to standardised duration of progesterone lu...
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research