Cochrane · systematic review · CD009154
Luteal phase support for assisted reproduction cycles
van der Linden, M, Buckingham, K, Farquhar, C, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
30
current version
GRADE rated
27
No studies
3
Included studies
NR
No studies 3 · 10%Ungraded 0 · 0%Very low 10 · 33.3%Low 15 · 50%Moderate 2 · 6.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyhCG compared with placebo/no treatment for assisted reproduction cycles
Population: subfertile women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy hCG vs placebo/no treatment | OR 1.76 [1.08, 2.86] | 3 studies · 527 participants | Very low Downgraded: risk of bias |
Clinical pregnancy hCG vs placebo/no treatment | OR 1.3 [0.9, 1.88] | 5 studies · 746 participants | Very low Downgraded: risk of bias |
OHSS hCG vs placebo/no treatment | OR 4.28 [1.91, 9.6] | 1 study · 387 participants | Low Downgraded: risk of bias |
Progesterone compared with placebo/no treatment for assisted reproduction cycles
Population: subfertile women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy Progesterone vs placebo/no treatment | OR 1.77 [1.09, 2.86] | 5 studies · 642 participants | Very low Downgraded: risk of bias |
Clinical pregnancy Progesterone vs placebo/no treatment | OR 1.89 [1.3, 2.75] | 7 studies · 841 participants | Low Downgraded: risk of bias |
OHSS Progesterone vs placebo/no treatment | no estimate extracted | NR | No studies |
Progesterone compared with hCG regimens for assisted reproduction cycles
Population: subfertile women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy Progesterone vs hCG regimens | OR 0.95 [0.65, 1.38] | 5 studies · 833 participants | Low Downgraded: risk of bias |
Clinical pregnancy Progesterone vs hCG regimens | OR 1.08 [0.9, 1.3] | 16 studies · 2355 participants | Moderate Downgraded: risk of bias |
OHSS Progesterone vs hCG regimens | OR 0.46 [0.3, 0.71] | 5 studies · 1293 participants | Low Downgraded: risk of bias |
Progesterone compared with progesterone + oestrogen for assisted reproduction cycles
Population: subfertile women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy Progesterone vs progesterone + oestrogen | OR 1.12 [0.91, 1.38] | 9 studies · 1651 participants | Low Downgraded: risk of bias |
Clinical pregnancy Progesterone vs progesterone + oestrogen | OR 0.86 [0.72, 1.04] | 14 studies · 2169 participants | Low Downgraded: risk of bias |
OHSS Progesterone vs progesterone + oestrogen | OR 0.58 [0.2, 1.68] | 2 studies · 461 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Progesterone compared with progesterone + GnRH agonist for assisted reproduction cycles
Population: women who had undergone IVF/ICSI
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy Progesterone vs progesterone + GnRH agonist | OR 0.62 [0.48, 0.81] | 9 studies · 2861 participants | Very low Downgraded: inconsistency |
Clinical pregnancy Progesterone vs progesterone + GnRH agonist | OR 0.66 [0.51, 0.85] | 8 studies · 2435 participants | Low Downgraded: risk of bias, inconsistency |
OHSS Progesterone vs progesterone + GnRH agonist | OR 1 [0.33, 3.01] | 1 study · 300 participants | Very low Downgraded: risk of bias, inconsistency |
Progesterone regimens for assisted reproduction cycles
Population: subfertile women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy IM vs oral | OR 0.71 [0.14, 3.66] | 1 study · 40 participants | Very low Downgraded: risk of bias |
Live birth or ongoing pregnancy IM vs vaginal/rectal | OR 1.24 [1.03, 1.5] | 7 studies · 2309 participants | Very low Downgraded: risk of bias |
Live birth or ongoing pregnancy Vaginal/rectal vs oral | OR 1.19 [0.83, 1.69] | 4 studies · 857 participants | Low Downgraded: risk of bias |
Live birth or ongoing pregnancy Low dose vaginal vs high dose vaginal | OR 0.97 [0.84, 1.11] | 5 studies · 3720 participants | Moderate Downgraded: risk of bias |
Live birth or ongoing pregnancy Short protocol vs long protocol | OR 1.04 [0.79, 1.36] | 5 studies · 1205 participants | Low Downgraded: risk of bias |
Live birth or ongoing pregnancy Micronised vs synthetic | OR 0.9 [0.53, 1.55] | 2 studies · 470 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Live birth or ongoing pregnancy Vaginal ring vs vaginal gel | OR 1.09 [0.88, 1.36] | 1 study · 1271 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Live birth or ongoing pregnancy Subcutaneous vs vaginal gel | OR 0.92 [0.74, 1.14] | 2 studies · 1465 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Live birth or ongoing pregnancy Vaginal vs rectal | OR 1.28 [0.64, 2.54] | 1 study · 147 participants | Very low Downgraded: risk of bias |
OHSS IM vs oral | OR 1 [0.06, 17.18] | 1 study · 40 participants | Very low Downgraded: risk of bias |
OHSS Low dose vaginal vs high dose vaginal | OR 0.91 [0.57, 1.46] | 2 studies · 1251 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Progesterone + oestrogen regimens for assisted reproduction cycles
Population: subfertile women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth/ongoing pregnancy ‐ short vs long protocol | OR 1.08 [0.81, 1.43] | 1 study · 910 participants | Low Downgraded: risk of bias |
Live birth/ongoing pregnancy ‐ low vs high dose protocol | OR 0.65 [0.37, 1.13] | 1 study · 285 participants | Very low Downgraded: risk of bias |
OHSS ‐ short vs long protocol | no estimate extracted | NR | No studies |
OHSS ‐ low vs high dose protocol | no estimate extracted | NR | No studies |
Human chorionic gonadotropin (hCG) versus placebo or no treatment for assisted reproduction cycles
Population: patients with assisted reproduction cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live Birth Rate Human chorionic gonadotropin (hCG) vs placebo or no treatment | OR 2.25 [0.37, 13.8] | 1 study · 38 participants | Low Downgraded: risk of bias, publication bias |
Clinical Pregnancy Rate Human chorionic gonadotropin (hCG) vs placebo or no treatment | OR 1.3 [0.9, 1.88] | 5 studies · 746 participants | Low Downgraded: risk of bias, publication bias |
OHSS Human chorionic gonadotropin (hCG) vs placebo or no treatment | OR 3.62 [1.85, 7.06] | 1 study · 387 participants | Low Downgraded: risk of bias, publication bias |
Progesterone versus placebo or no treatment for assisted reproduction cycles
Population: patients with assisted reproduction cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live Birth Rate Progesterone vs placebo or no treatment | OR 2.95 [1.02, 8.56] | 1 study · 156 participants | Low Downgraded: risk of bias, publication bias |
Clinical Pregnancy Rate Progesterone vs placebo or no treatment | OR 1.83 [1.29, 2.61] | 7 studies · 841 participants | Low Downgraded: risk of bias, publication bias |
OHSS Progesterone vs placebo or no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Progesterone versus hCG regimens for assisted reproduction cycles
Population: patients with assisted reproduction cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live Birth Rate ‐ versus hCG Progesterone vs hCG regimens | OR 0.41 [0.14, 1.18] | 2 studies · 203 participants | Low Downgraded: risk of bias, publication bias |
Live Birth Rate ‐ versus progesterone + hCG Progesterone vs hCG regimens | OR 0.52 [0.12, 2.16] | 1 study · 132 participants | Low Downgraded: risk of bias, publication bias |
Clinical Pregnancy Rate ‐ versus hCG Progesterone vs hCG regimens | OR 1.14 [0.9, 1.45] | 10 studies · 1448 participants | Moderate Downgraded: risk of bias |
Clinical Pregnancy Rate ‐ versus progesterone + hCG Progesterone vs hCG regimens | OR 0.96 [0.74, 1.25] | 7 studies · 1080 participants | Moderate Downgraded: risk of bias, publication bias |
OHSS ‐ versus hCG Progesterone vs hCG regimens | OR 0.63 [0.38, 1.03] | 4 studies · 706 participants | Moderate Downgraded: risk of bias |
OHSS ‐ versus progesterone + hCG Progesterone vs hCG regimens | OR 0.45 [0.26, 0.79] | 3 studies · 713 participants | Very low Downgraded: risk of bias, inconsistency |
Progesterone versus progesterone + estrogen for assisted reproduction cycles
Population: patients with assisted reproduction cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live Birth Rate Progesterone vs progesterone + estrogen | OR 1.13 [0.43, 2.94] | 1 study · 100 participants | Low Downgraded: risk of bias, publication bias |
Clinical Pregnancy Rate Progesterone vs progesterone + estrogen | OR 0.8 [0.63, 1.02] | 7 studies · 1345 participants | Low Downgraded: inconsistency, publication bias |
OHSS Progesterone vs progesterone + estrogen | OR 0.14 [0.01, 2.21] | 1 study · 59 participants | Low Downgraded: risk of bias, publication bias |
Progesterone versus progesterone + GnRH agonist for assisted reproduction cycles
Population: patients with assisted reproduction cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live Birth Rate Progesterone vs progesterone + GnRH agonist | OR 0.41 [0.26, 0.61] | 3 studies · 455 participants | Moderate Downgraded: publication bias |
Clinical Pregnancy Rate Progesterone vs progesterone + GnRH agonist | OR 0.74 [0.6, 0.9] | 6 studies · 1646 participants | Moderate Downgraded: inconsistency, publication bias |
OHSS Progesterone vs progesterone + GnRH agonist | no estimate extracted | 0 studies · 0 participants | Ungraded |
Progesterone regimens for luteal phase support
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live Birth Rate ‐ IM versus Oral | OR 0.71 [0.14, 3.57] | 1 study · 40 participants | Low Downgraded: risk of bias, publication bias |
Live Birth Rate ‐ IM versus Vaginal/rectal | OR 1.17 [0.91, 1.51] | 4 studies · 1222 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Live Birth Rate ‐ Vaginal/rectal versus Oral | OR 0.99 [0.66, 1.48] | 2 studies · 713 participants | Low Downgraded: risk of bias, publication bias |
Live Birth Rate ‐ Low dose vaginal versus high dose vaginal | OR 0.99 [0.79, 1.24] | 2 studies · 1485 participants | Moderate Downgraded: risk of bias, publication bias |
Live Birth Rate ‐ Short protocol versus long protocol | OR 0.88 [0.4, 1.95] | 1 study · 97 participants | Low Downgraded: risk of bias, publication bias |
Live Birth Rate ‐ Micronized versus synthetic | OR 0.9 [0.52, 1.56] | 2 studies · 470 participants | Low Downgraded: risk of bias, publication bias |