Does progesterone supplementation improve pregnancy rates in clomiphene citrate and intrauterine insemination treatment cycles?

Elguero, Sonia; Wyman, Allison; Hurd, William W.; Barker, Nichole M.; Patel, Brijesh; Liu, James H.

doi:10.3109/09513590.2014.981803

Cited by 5 publications

(8 citation statements)

References 26 publications

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“…The study resulted in an increase of clinical pregnancy rate in the CC + EE group (29 % vs 10 %, p = 0.02) even if there was no statistically significant difference in the ongoing pregnancy rate between the two groups [ 48 ]. However, an interesting recent retrospective cohort analysis revealed that luteal phase progesterone supplementation in CC-IUI cycles can improve endometrial receptivity with an effect closely related to the endometrial thickness [ 49 ]. Patients who appeared to receive the greatest benefit of progesterone supplementation had an endometrial thickness of 6–8 mm; their clinical pregnancy rate was found to be improved two-fold (OR 2.04; 95 % CI 1.01 to 4.14) [ 49 ].…”

Section: Non-gonadotropin Induced Ovulatory Cyclesmentioning

confidence: 99%

“…However, an interesting recent retrospective cohort analysis revealed that luteal phase progesterone supplementation in CC-IUI cycles can improve endometrial receptivity with an effect closely related to the endometrial thickness [ 49 ]. Patients who appeared to receive the greatest benefit of progesterone supplementation had an endometrial thickness of 6–8 mm; their clinical pregnancy rate was found to be improved two-fold (OR 2.04; 95 % CI 1.01 to 4.14) [ 49 ]. These patients seem to have an endometrium still receptive to progesterone administration, whereas patients with an endometrial thickness less than 6 mm are not responsive to progesterone supplementation for CC-related receptors depletion/inhibition and patients with an endometrial thickness greater than 8 mm represent a group with good reproductive prognosis in which progesterone supplementation is unable to provide further reproductive improvement.…”

Section: Non-gonadotropin Induced Ovulatory Cyclesmentioning

confidence: 99%

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Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?

2015

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Luteal phase deficiency (LPD) is described as a condition of insufficient progesterone exposure to maintain a regular secretory endometrium and allow for normal embryo implantation and growth. Recently, scientific focus is turning to understand the physiology of implantation, in particular the several molecular markers of endometrial competence, through the recent transcriptomic approaches and microarray technology. In spite of the wide availability of clinical and instrumental methods for assessing endometrial competence, reproducible and reliable diagnostic tests for LPD are currently lacking, so no type-IA evidence has been proposed by the main scientific societies for assessing endometrial competence in infertile couples. Nevertheless, LPD is a very common condition that may occur during a series of clinical conditions, and during controlled ovarian stimulation (COS) and hyperstimulation (COH) programs. In many cases, the correct approach to treat LPD is the identification and correction of any underlying condition while, in case of no underlying dysfunction, the treatment becomes empiric. To date, no direct data is available regarding the efficacy of luteal phase support for improving fertility in spontaneous cycles or in non-gonadotropin induced ovulatory cycles. On the contrary, in gonadotropin in vitro fertilization (IVF) and non-IVF cycles, LPD is always present and progesterone exerts a significant positive effect on reproductive outcomes. The scientific debate still remains open regarding progesterone administration protocols, specially on routes of administration, dose and timing and the potential association with other drugs, and further research is still needed.

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Section: Non-gonadotropin Induced Ovulatory Cyclesmentioning

confidence: 99%

Section: Non-gonadotropin Induced Ovulatory Cyclesmentioning

confidence: 99%

Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?

2015

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“…In the final analysis, 105 eligible studies (19 prospective and 86 retrospective cohort studies) were included, involving more than 271,632 pregnant women (Figure 1). 14,15,28–130 The main characteristics of included studies were summarized in Table S1. In total, 100 studies reported the association between maternal BMI and CPR among pregnant women undergoing ART, among which 53 reported MR and 51 reported LBR (Table S1).…”

Section: Resultsmentioning

confidence: 99%

“…In total, 100 studies reported the association between maternal prepregnancy body weight and CPR after ART 14,15,28–55,58–80,82–117,119–122,124–130 . At per‐woman level, 54 studies, involving 109,688 pregnant women, showed an inverted J‐shaped relationship between maternal BMI and CPR ( P n < 0.01) 14,28–31,34–36,40,41,44,46,47,49,53,58,60,61,64–68,75,76,78,82,85,86,88–95,97,99,103–106,109,112–114,119,121,124,126–128,130 .…”

Section: Resultsmentioning

confidence: 99%

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Association between maternal prepregnancy body mass index and pregnancy outcomes following assisted reproductive technology: A systematic review and dose–response meta‐analysis

et al. 2021

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Summary This systematic review investigated dose–response relationship between maternal prepregnancy body mass index (BMI) and pregnancy outcomes following assisted reproductive technology, including clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR). We searched four major databases and finally included 105 studies involving more than 271,632 pregnant women. We performed linear or nonlinear dose–response meta‐analyses using random effects models. At per‐woman level, pooling of unadjusted estimates shown an inverted J‐shaped relationship between maternal BMI and CPR; pooling of adjusted estimates showed a linear association, suggesting statistical association between higher maternal BMI and lower CPR (adjusted OR [aOR] for 5‐unit increase in BMI: 0.96, 95%CI: 0.94–0.98). At per‐cycle level, linear dose–response relationship was found between maternal BMI and CPR (crude relative risk, RR, [cRR] for 5‐unit increase in BMI 0.97, 0.96–0.98; aOR 0.96, 0.94–0.99). Linear dose–response relationship was established between maternal BMI and the outcomes of MR or LBR (higher BMI associated with higher MR [cRR 1.15, 1.08–1.22] and lower LBR [cRR 0.91, 0.88–0.94] at per‐woman level). Sensitivity analyses showed no significant changes. In conclusion, there is dose–response relationship between maternal BMI and pregnancy outcomes following assisted reproductive technology. Higher BMI values may suggest suboptimal pregnancy outcomes.

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The role of steroid hormone supplementation in non–assisted reproductive technology treatments for unexplained infertility

Quaas

Hansen

2016

Fertility and Sterility

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Fertility treatment strategies are evolving, with a more rapid transition to assisted reproductive technology (ART) treatments after unsuccessful non-ART treatments. This trend increases the potential importance of adjuvant treatments in non-ART cycles, such as steroid hormone supplementation. It has been established that success rates of ART treatments are increased with the use of luteal support with progesterone. In the setting of non-ART cycles, however, the evidence is less clear, and clinical practices vary widely between providers and clinics. In this review, we aimed to provide an overview of the current evidence for the use of steroid hormone supplementation, including progesterone for luteal support, estrogens, androgens, and mineralocorticoids, in the setting of non-ART treatments for ovulatory women.

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Does progesterone supplementation improve pregnancy rates in clomiphene citrate and intrauterine insemination treatment cycles?

Abstract: Luteal phase progesterone supplementation in CC-IUI cycles can improve endometrial receptivity as judged by the improved clinical pregnancy rates as the primary outcome.

Cited by 5 publications

References 26 publications

Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?

Progesterone administration for luteal phase deficiency in human reproduction: an old or new issue?

Association between maternal prepregnancy body mass index and pregnancy outcomes following assisted reproductive technology: A systematic review and dose–response meta‐analysis

The role of steroid hormone supplementation in non–assisted reproductive technology treatments for unexplained infertility

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