Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Effect of luteal phase support with vaginal progesterone on pregnancy outcomes in natural frozen embryo transfer cycles: A meta-analysis

  • Seol, Aeran (Department of Obstetrics and Gynecology, Seoul National University Hospital) ;
  • Shim, Yoo Jin (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Kim, Sung Woo (Department of Obstetrics and Gynecology, Seoul National University Hospital) ;
  • Kim, Seul Ki (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Lee, Jung Ryeol (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Jee, Byung Chul (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Suh, Chang Suk (Department of Obstetrics and Gynecology, Seoul National University Hospital) ;
  • Kim, Seok Hyun (Department of Obstetrics and Gynecology, Seoul National University Hospital)
  • Received : 2019.07.01
  • Accepted : 2019.11.11
  • Published : 2020.06.30
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Abstract

Objective: The purpose of this study was to determine the effect of vaginal progesterone for luteal phase support (LPS) on the clinical pregnancy rate (CPR) in natural frozen embryo transfer (FET) cycles via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective studies that met our selection criteria. Four online databases (PubMed, Embase, Medline, and the Cochrane Library) were searched between January 2017 and May 2017. Studies were selected according to predefined inclusion criteria and meta-analyzed using R software version 2.14.2. The main outcome measure was CPR. Results: A total of 18 studies were reviewed and assessed for eligibility. One RCT (n = 435) and three retrospective studies (n = 3,033) met the selection criteria. In a meta-analysis of the selected studies, we found no significant difference in the CPR (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.60-1.55) between the vaginal progesterone and control groups. An analysis of the two retrospective cohort studies that reported the live birth rate (LBR) following FET showed a significantly higher LBR in the vaginal progesterone group (OR, 1.72; 95% CI, 1.21-2.46). A subgroup meta-analysis of FET conducted 5 days after injection of human chorionic gonadotropin showed no significant differences between the two groups with regard to the CPR (OR, 1.18; 95% CI, 0.90-1.55) or miscarriage rate (OR, 0.73; 95% CI, 0.36-1.47). Conclusion: The results of this meta-analysis of the currently available literature suggest that LPS with vaginal progesterone in natural FET cycles does not improve the CPR.

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References

  1. Csapo AI, Pulkkinen MO, Ruttner B, Sauvage JP, Wiest WG. The significance of the human corpus luteum in pregnancy maintenance. I. Preliminary studies. Am J Obstet Gynecol 1972;112:1061-7. https://doi.org/10.1016/0002-9378(72)90181-0
  2. Szekeres-Bartho J, Wilczynski JR, Basta P, Kalinka J. Role of progesterone and progestin therapy in threatened abortion and preterm labour. Front Biosci 2008;13:1981-90. https://doi.org/10.2741/2817
  3. Daya S. Luteal support: progestogens for pregnancy protection. Maturitas 2009;65 Suppl 1:S29-34. https://doi.org/10.1016/j.maturitas.2009.09.012
  4. Kimzey LM, Gumowski J, Merriam GR, Grimes GJ Jr, Nelson LM. Absorption of micronized progesterone from a nonliquefying vaginal cream. Fertil Steril 1991;56:995-6. https://doi.org/10.1016/s0015-0282(16)54680-9
  5. Khan N, Richter KS, Newsome TL, Blake EJ, Yankov VI. Matchedsamples comparison of intramuscular versus vaginal progesterone for luteal phase support after in vitro fertilization and embryo transfer. Fertil Steril 2009;91:2445-50. https://doi.org/10.1016/j.fertnstert.2008.03.072
  6. Salat-Baroux J, Cornet D, Alvarez S, Antoine JM, Tibi C, Mandelbaum J, et al. Pregnancies after replacement of frozen-thawed embryos in a donation program. Fertil Steril 1988;49:817-21. https://doi.org/10.1016/s0015-0282(16)59890-2
  7. Kyrou D, Fatemi HM, Popovic-Todorovic B, Van den Abbeel E, Camus M, Devroey P. Vaginal progesterone supplementation has no effect on ongoing pregnancy rate in hCG-induced natural frozen-thawed embryo transfer cycles. Eur J Obstet Gynecol Reprod Biol 2010;150:175-9. https://doi.org/10.1016/j.ejogrb.2010.02.038
  8. Kim CH, Lee YJ, Lee KH, Kwon SK, Kim SH, Chae HD, et al. The effect of luteal phase progesterone supplementation on natural frozen-thawed embryo transfer cycles. Obstet Gynecol Sci 2014;57:291-6. https://doi.org/10.5468/ogs.2014.57.4.291
  9. Bjuresten K, Landgren BM, Hovatta O, Stavreus-Evers A. Luteal phase progesterone increases live birth rate after frozen embryo transfer. Fertil Steril 2011;95:534-7. https://doi.org/10.1016/j.fertnstert.2010.05.019
  10. Montagut M, Santos-Ribeiro S, De Vos M, Polyzos NP, Drakopoulos P, Mackens S, et al. Frozen-thawed embryo transfers in natural cycles with spontaneous or induced ovulation: the search for the best protocol continues. Hum Reprod 2016;31:2803-10. https://doi.org/10.1093/humrep/dew263

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