12.11Progesterone for luteal support

StudyPopulationInterventionOutcomesResultsCommentsStudy typeEL
Daya 19889725 RCTs (1142 participants)Progesterone support following IVF-embryo transfer or GIFT versus no treatmentPregnancy rateNo significant difference:

OR 1.25 (CI 0.93 to 1.66)
Demographic details of women in study limited

All women received ovarian stimulation with CC + hMG, and hCG for ovulation induction
Soliman et al. 199486618 RCTshCG versus no treatment

Progesterone versus no treatment

hCG versus progesterone ± GnRHa use
Pregnancy rate/cycle

Spontaneous abortion rate

Significant difference:

Pregnancy rate/cycle:

hCG versus no treatment: OR 1.9 (CI 1.3 to 3.1)

Progesterone versus no treatment: OR 1.2 (CI 1.0 to 1.7)

hCG versus progesterone OR 2.0 (CI 1.1 to 3.9)

No significant difference:

Spontaneous abortion rate:
Luteal support versus none: OR 0.8 (CI 0.4 to 1.7)

hCG: 11/220 (5%)

Progesterone or no treatment:
0/193 (0%)
Pritts et al. 200297330 RCTshCG versus none

Progesterone versus none

Intramuscular/oral progesterone versus vaginal progesterone

hCG versus progesterone

E2 + P versus progesterone

Different doses of hCG/progesterone
Clinical pregnancy rate

Ongoing pregnancy rate

Delivery rate

Implantation rate

Miscarriage rate
Significant difference:

Intramuscular hCG versus no treatment:
Clinical pregnancy rate:
RR 2.72 (CI 1.56 to 4.90)

Intramuscular progesterone versus placebo (long GnRHa protocol):
Clinical pregnancy rate:
RR 2.38 (CI 1.36 to 4.27)
Ongoing pregnancy rate:
RR 3.8 (CI 1.42 to 11.38)
Delivery rate:
RR (5.50 (CI 1.25 to 35.53)
Vaginal versus oral progesterone:
Implantation rate:
RR 1.5 (CI 1.10 to 2.05)
Intramuscular hCG versus oral progesterone (short GnRHa protocol):
Clinical pregnancy rate: RR 8.36 (CI 1.44 to 173.74)
Ongoing pregnancy rate: RR 7.43 (CI 1.22 to 156.64)

Intramuscular versus vaginal progesterone (long GnRHa protocol):
Clinical pregnancy rate: RR 1.33 (CI 1.02 to 1.75)
Delivery rate: RR 2.06 (CI 1.48 to 2.88)

E2 + progesterone versus progesterone only (long GnRHa protocol): RR 1.49 (CI 1.02 to 2.19)

No significant differences in Clinical pregnancy, ongoing pregnancy, delivery and miscarriage rates for the following:

Vaginal progesterone versus no treatment

Different doses of progesterone

Intramuscular versus oral progesterone

Intramuscular hCG versus oral progesterone (long GnRHa protocol)

Intramuscular hCG versus IM progesterone (long GnRHa protocol)

E2 + progesterone versus progesterone only (long GnRHa protocol)

hCG + progesterone versus vaginal progesterone (long and short GnRHa protocol)

Intramuscular progesterone + E2 versus hCG

From: Evidence tables

Cover of Fertility
Fertility: Assessment and Treatment for People with Fertility Problems.
NICE Clinical Guidelines, No. 11.
National Collaborating Centre for Women's and Children's Health (UK).
London (UK): RCOG Press; 2004 Feb.
Copyright © 2004, National Collaborating Centre for Women’s and Children’s Health.

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