Timing luteal support in assisted reproductive technology: a systematic review.

Abstract:

OBJECTIVE:To summarize the available published randomized controlled trial data regarding timing of P supplementation during the luteal phase of patients undergoing assisted reproductive technology (ART). DESIGN:A systematic review. SETTING:Not applicable. PATIENT(S):Undergoing IVF. INTERVENTION(S):Different starting times of P for luteal support. MAIN OUTCOME MEASURE(S):Clinical pregnancy (PR) and live birth rates. RESULT(S):Five randomized controlled trials were identified that met inclusion criteria with a total of 872 patients. A planned meta-analysis was not performed because of a high degree of clinical heterogeneity with regard to the timing, dose, and route of P. Two studies compared P initiated before oocyte retrieval versus the day of oocyte retrieval and PRs were 5%-12% higher when starting P on the day of oocyte retrieval. One study compared starting P on day 6 after retrieval versus day 3, reporting a 16% decrease in pregnancy in the day 6 group. Trials comparing P start times on the day of oocyte retrieval versus 2 or 3 days after retrieval showed no significant differences in pregnancy. CONCLUSION(S):There appears to be a window for P start time between the evening of oocyte retrieval and day 3 after oocyte retrieval. Although some studies have suggested a potential benefit in delaying vaginal P start time to 2 days after oocyte retrieval, this review could not find randomized controlled trials to adequately assess this. Further randomized clinical trials are needed to better define P start time for luteal support after ART.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Connell MT,Szatkowski JM,Terry N,DeCherney AH,Propst AM,Hill MJ

doi

10.1016/j.fertnstert.2014.12.125

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

939-946.e3

issue

4

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(14)02556-4

journal_volume

103

pub_type

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