Cochrane · systematic review · CD012396
Luteal phase support for women trying to conceive by intrauterine insemination or sexual intercourse
Salang, L, Teixeira, DM, Solà, I, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
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
49
current version
GRADE rated
35
No studies
14
Included studies
NR
No studies 14 · 28.6%Ungraded 0 · 0%Very low 19 · 38.8%Low 16 · 32.7%Moderate 0 · 0%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
Progesterone compared to no treatment or placebo (route of progesterone administration) for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes* Progesterone vs no treatment or placebo (route of progesterone administration) | no estimate extracted | NR | No studies |
Live birth/ongoing pregnancy rate Progesterone vs no treatment or placebo (route of progesterone administration) | RR 1.1 [0.81, 1.48] | 7 studies · 1792 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage per clinical pregnancy Progesterone vs no treatment or placebo (route of progesterone administration) | RR 0.7 [0.4, 1.25] | 5 studies · 261 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy per woman Progesterone vs no treatment or placebo (route of progesterone administration) | RR 1.35 [1.14, 1.61] | 13 studies · 2794 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy per woman ‐ oral route Progesterone vs no treatment or placebo (route of progesterone administration) | RR 0.67 [0.4, 1.13] | 1 study · 99 participants | Very low Downgraded: risk of bias, imprecision |
Multiple pregnancy per woman Progesterone vs no treatment or placebo (route of progesterone administration) | RR 0.84 [0.3, 2.34] | 3 studies · 956 participants | Low Downgraded: risk of bias, imprecision |
Adverse events, OHSS, preterm delivery, congenital anomaly Progesterone vs no treatment or placebo (route of progesterone administration) | no estimate extracted | NR | No studies |
Progesterone compared to placebo/no treatment for gonadotropin stimulation for women trying to conceive by intrauterine insemination
Population: women with gonadotropin stimulation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate/ongoing pregnancy rate Progesterone vs placebo/no treatment | RR 1.24 [0.8, 1.92] | 4 studies · 1054 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage rate per clinical pregnancy Progesterone vs placebo/no treatment | RR 0.68 [0.24, 1.91] | 2 studies · 102 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate Progesterone vs placebo/no treatment | RR 1.38 [1.1, 1.74] | 7 studies · 1437 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate Progesterone vs placebo/no treatment | RR 0.72 [0.17, 3.15] | 1 study · 214 participants | Low Downgraded: risk of bias, imprecision |
Adverse events, OHSS, preterm delivery, congenital anomaly Progesterone vs placebo/no treatment | no estimate extracted | NR | No studies |
Progesterone compared to placebo/no treatment for gonadotropin plus oral (clomiphene citrate/letrozole) stimulation for women trying to conceive by intrauterine insemination
Population: women with gonadotropin plus oral (clomiphene citrate or letrozole) stimulation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Progesterone vs placebo/no treatment | no estimate extracted | NR | No studies |
Ongoing pregnancy rate Progesterone vs placebo/no treatment | RR 0.73 [0.37, 1.42] | 1 study · 253 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage rate per clinical pregnancy Progesterone vs placebo/no treatment | RR 0.67 [0.3, 1.5] | 2 studies · 123 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate Progesterone vs placebo/no treatment | RR 1.4 [1.03, 1.9] | 4 studies · 733 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate Progesterone vs placebo/no treatment | RR 1.44 [0.24, 8.49] | 1 study · 290 participants | Low Downgraded: risk of bias, imprecision |
Adverse events, OHSS, preterm delivery, congenital anomaly Progesterone vs placebo/no treatment | no estimate extracted | NR | No studies |
Progesterone compared to placebo/no treatment for oral (clomiphene citrate or letrozole) stimulation for women trying to conceive by intrauterine insemination
Population: women with oral (clomiphene citrate or letrozole) stimulation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate/ongoing pregnancy Progesterone vs placebo/no treatment | RR 0.97 [0.58, 1.64] | 2 studies · 485 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage rate per clinical pregnancy Progesterone vs placebo/no treatment | RR 0.53 [0.25, 1.14] | 2 studies · 119 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy Progesterone vs placebo/no treatment | RR 1.44 [1.04, 1.98] | 6 studies · 1073 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy Progesterone vs placebo/no treatment | RR 0.58 [0.1, 3.55] | 2 studies · 586 participants | Low Downgraded: risk of bias, imprecision |
Adverse events, OHSS, preterm delivery, congenital anomaly Progesterone vs placebo/no treatment | no estimate extracted | NR | No studies |
300 mg vaginal progesterone compared to 600 mg vaginal progesterone for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ongoing pregnancy rate 300 mg vaginal progesterone vs 600 mg vaginal progesterone | RR 1.58 [0.81, 3.09] | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate 300 mg vaginal progesterone vs 600 mg vaginal progesterone | RR 0.5 [0.05, 5.43] | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision |
Intramuscular (IM) progesterone compared to vaginal progesterone for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Intramuscular (IM) progesterone vs vaginal progesterone | no estimate extracted | NR | No studies |
Ongoing pregnancy rate Intramuscular (IM) progesterone vs vaginal progesterone | RR 0.59 [0.34, 1.02] | 1 study · 225 participants | Very low Downgraded: risk of bias, imprecision |
Miscarriage rate Intramuscular (IM) progesterone vs vaginal progesterone | RR 0.75 [0.43, 1.32] | 1 study · 81 participants | Very low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate Intramuscular (IM) progesterone vs vaginal progesterone | RR 0.78 [0.55, 1.11] | 1 study · 225 participants | Very low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate Intramuscular (IM) progesterone vs vaginal progesterone | no estimate extracted | NR | No studies |
Adverse events  Intramuscular (IM) progesterone vs vaginal progesterone | RR 9.25 [2.21, 38.78] | 1 study · 225 participants | Very low Downgraded: risk of bias, imprecision |
OHSS, preterm delivery, congenital anomaly Intramuscular (IM) progesterone vs vaginal progesterone | no estimate extracted | NR | No studies |
Oral progesterone compared to vaginal progesterone for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Oral progesterone vs vaginal progesterone | no estimate extracted | NR | No studies |
Ongoing pregnancy rate Oral progesterone vs vaginal progesterone | RR 1.25 [0.7, 2.22] | 1 study · 150 participants | Very low Downgraded: risk of bias, imprecision |
Miscarriage rate per clinical pregnancy Oral progesterone vs vaginal progesterone | RR 0.58 [0.11, 3.09] | 1 study · 41 participants | Very low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate Oral progesterone vs vaginal progesterone | RR 1.16 [0.69, 1.96] | 1 study · 150 participants | Very low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate Oral progesterone vs vaginal progesterone | no estimate extracted | NR | No studies |
Adverse events, OHSS, preterm delivery, congenital anomaly Oral progesterone vs vaginal progesterone | no estimate extracted | NR | No studies |
Aqueous subcutaneous (Sc) progesterone compared to vaginal progesterone gel for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ongoing pregnancy rate Aqueous subcutaneous (Sc) progesterone vs vaginal progesterone gel | RR 1.05 [0.54, 2.05] | 1 study · 246 participants | Very low Downgraded: risk of bias |
Clinical pregnancy rate Aqueous subcutaneous (Sc) progesterone vs vaginal progesterone gel | RR 1.12 [0.59, 2.11] | 1 study · 246 participants | Very low Downgraded: risk of bias |
Subcutaneous (Sc) gonadotropin‐releasing hormone (GnRH) agonist compared to placebo/no treatment for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth Subcutaneous (Sc) gonadotropin‐releasing hormone (GnRH) agonist vs placebo/no treatment | no estimate extracted | NR | No studies |
Ongoing pregnancy rate Subcutaneous (Sc) gonadotropin‐releasing hormone (GnRH) agonist vs placebo/no treatment | RR 1.1 [0.7, 1.74] | 1 study · 291 participants | Very low Downgraded: risk of bias, imprecision |
Miscarriage rate Subcutaneous (Sc) gonadotropin‐releasing hormone (GnRH) agonist vs placebo/no treatment | RR 0.73 [0.26, 2.1] | 2 studies · 79 participants | Very low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate Subcutaneous (Sc) gonadotropin‐releasing hormone (GnRH) agonist vs placebo/no treatment | RR 1 [0.68, 1.47] | 2 studies · 340 participants | Very low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate Subcutaneous (Sc) gonadotropin‐releasing hormone (GnRH) agonist vs placebo/no treatment | RR 0.28 [0.11, 0.7] | 2 studies · 126 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events, OHSS, preterm delivery, congenital anomaly Subcutaneous (Sc) gonadotropin‐releasing hormone (GnRH) agonist vs placebo/no treatment | no estimate extracted | NR | No studies |
Vaginal progesterone compared to gonadotropin‐releasing hormone (GnRH) agonist for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical pregnancy rate Vaginal progesterone vs gonadotropin‐releasing hormone (GnRH) agonist | RR 1 [0.51, 1.95] | 1 study · 242 participants | Very low Downgraded: risk of bias, imprecision |
Human chorionic gonadotropin (hCG) injection compared to no treatment for women trying to conceive by intrauterine insemination
Population: women trying to conceive by intrauterine insemination
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical pregnancy rate Human chorionic gonadotropin (hCG) injection vs no treatment | RR 0.93 [0.4, 2.13] | 1 study · 130 participants | Very low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate Human chorionic gonadotropin (hCG) injection vs no treatment | RR 1.03 [0.22, 4.92] | 1 study · 130 participants | Very low Downgraded: risk of bias, imprecision |