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

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.Capsule Luteal phase support with vaginal progesterone in women undergoing intrauterine insemination significantly improves live birth rate. E. Miralpeix : M. González-Comadran : R. Carreras :

Does Progesterone Suppository to Luteal Phase Support Have Any Effect on Pregnancy Rates in the Intrauterine Insemination Cycles?

“…LH secretion in infertility treatment cycle may be was in low level 10 days after the treatment with GNRH agonist and unsatisfactory to luteal stage support [6]. The medical scientists believe that luteal phase support by any types of progesterone is necessary in ovulation induction of intrauterine insemination cycles and can elevate pregnancy rate and reduces abortion rate [7][8][9].…”

Gonadotropins for Women with Unexplained Infertility

“…Several studies have looked into the prospect of luteal phase support with vaginal progesterone in IUI. The two most recent systematic reviews and meta-analyses analysed 5 RCTs and have concluded that vaginal progesterone supplementation significantly improves live birth rates in IUI cycles stimulated with gonadotropins [55,56].…”

Impact of routine hysteroscopy (HS) prior to intrauterine insemination (IUI) on pregnancy rates (PR) among infertile couples at Al-Amal Hospital, Misurata, Libya

“…Its utilization has increased in the recent decades because it is a simple, non-invasive, and a cost-effective technique compared to other ART procedures [22]. To increase the success rate of IUI, it has been performed generally in combination with controlled ovarian hyperstimulation (COH) using Clomiphene citrate or Gonadotropin or their combination [23,24]. The aim of this study was to assess the diagnostic and therapeutic value of HS in primary assessment before IUI in infertile couples with the main outcome measure studied was conception / PR.…”