Cochrane · systematic review · CD013827
Progestogens for prevention of luteinising hormone (LH) surge in women undergoing controlled ovarian hyperstimulation as part of an assisted reproductive technology (ART) cycle
Glujovsky, D, Pesce, R, Miguens, M, et al. · Cochrane Database of Systematic Reviews · 2023 · 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
48
current version
GRADE rated
21
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 27 · 56.3%Very low 4 · 8.3%Low 9 · 18.8%Moderate 5 · 10.4%High 3 · 6.3%
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
Summary of findings table ‐ Progestogens compared to GnRH antagonists for assisted reproduction technology cycles
Population: assisted reproduction technology cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy ‐ total Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 1 participants | Very low Downgraded: risk of bias, imprecision |
Oocyte pick‐up cancellation ‐ total Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 0.92 [0.42, 2.01] | 3 studies · 648 participants | Low Downgraded: imprecision |
Clinical pregnancy ‐ Poor‐responders (MPA 10 mg versus GnRH antagonists) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 1.32 [0.81, 2.16] | 1 study · 340 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage ‐ total Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 2 studies · 2 participants | Very low Downgraded: risk of bias, imprecision |
Live birth or ongoing pregnancy ‐ Poor‐responders (MPA 10 mg versus GnRH antagonists) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 1.25 [0.73, 2.13] | 1 study · 340 participants | Ungraded |
Oocyte pick‐up cancellation ‐ Normoresponders (MPA 10 mg versus GnRH antagonists) ‐ Donor oocytes ‐ Early phase stimulation protocol ‐ Fresh embryo transfer Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 0.84 [0.28, 2.55] | 2 studies · 534 participants | Ungraded |
Oocyte pick‐up cancellation ‐ Normoresponders (micronised progesterone 200 mg versus GnRH antagonists) ‐ Own oocytes ‐ Early phase stimulation protocol ‐ Fresh embryo transfer Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 1 [0.33, 3.06] | 1 study · 114 participants | Ungraded |
Cumulative pregnancy rate Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 1 participants | Ungraded |
Premature LH surge ‐ Donor oocytes ‐ Normoresponders ‐ Early phase stimulation protocol ‐ Fresh embryo transfer Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 1 participants | Ungraded |
Premature LH surge ‐ Own oocytes ‐ PCOS (high‐responders) ‐ Early phase stimulation protocol ‐ Frozen embryo transfer Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 1 participants | Ungraded |
Total oocytes ‐ Normoresponders ‐ Donor oocytes ‐ Early phase stimulation protocol ‐ Fresh embryo transfer (MPA 10 mg/day versus GnRH antagonists) Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 2 studies · 534 participants | Ungraded |
Total oocytes ‐ PCOS (high‐responders) ‐ Own oocytes ‐ Early phase stimulation protocol ‐ Frozen embryo transfer (micronised progesterone 100 mg/day versus GnRH antagonists) Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 120 participants | Ungraded |
MII oocytes Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 0 studies · 0 participants | Ungraded |
Total dose of gonadotropins (IU) ‐ total Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 4 studies · 952 participants | Moderate Downgraded: inconsistency |
MII oocytes ‐ PCOS (high‐responders) ‐ Own oocytes ‐ Early phase stimulation protocol ‐ Frozen embryo transfer (micronised progesterone 100 mg/day versus GnRH antagonists) Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 120 participants | Ungraded |
Moderate or severe OHSS ‐ total Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 3 studies · 3 participants | High |
Duration of stimulation (days) ‐ PCOS (high‐responders) ‐ Own oocytes ‐ Early phase stimulation protocol ‐ Frozen embryo transfer (micronised progesterone 100 mg/day versus GnRH antagonists) Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 120 participants | Ungraded |
Total dose of gonadotropins (IU) ‐ Poor responders (MPA 10 mg versus GNrH antagoninsts ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 340 participants | Ungraded |
Total dose of gonadotropins (IU) ‐ Normoresponders ‐ Donor oocytes ‐ Early ophase stimulation protocol ‐ Fresh embryo transfer (MPA 10 mg/day versus GnRH antagonists Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 2 studies · 492 participants | Ungraded |
Total dose of gonadotropins (IU) ‐ PCOS (high‐responders) ‐ Own oocytes ‐ Early phase stumulation protocol ‐ Frozen embryo transfer (micronised progesterone 100 mg/day versus GnRH antagonists) Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 120 participants | Ungraded |
Moderate or severe OHSS ‐ Poor‐responders (MPA 10 mg versus GnRH antagonists) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 1 study · 1 participants | Ungraded |
Moderate or severe OHSS ‐ Normoresponders ‐ Donor oocytes ‐ Early phase stimulation protocol ‐ Fresh embryo transfer (MPA 10 mg/day versus GnRH antagonists) Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 2 studies · 2 participants | Ungraded |
Live birth or ongoing pregnancy sensitivity analysis ‐ Poor‐responders (MPA 10 mg versus GnRH antagonists) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 1.25 [0.73, 2.13] | 1 study · 340 participants | Ungraded |
Live birth or ongoing pregnancy sensitivity analysis ‐ PCOS (high‐responders) ‐ own oocytes ‐ early phase stimulation protocol ‐ frozen embryo transfer (micronised progesterone 100 mg/day versus GnRH antagonists) Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 1.87 [0.89, 3.91] | 1 study · 120 participants | Ungraded |
Live birth or ongoing pregnancy sensitivity analysis ‐ total Summary of findings table ‐ Progestogens vs GnRH antagonists | no estimate extracted | 2 studies · 2 participants | Ungraded |
Oocyte pick‐up cancellation sensitivity analysis ‐ Normoresponders (MPA 10 mg versus GnRH antagonists) ‐ Donor oocytes ‐ Early phase stimulation protocol ‐ Fresh embryo transfer Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 0.84 [0.28, 2.55] | 2 studies · 534 participants | Ungraded |
Oocyte pick‐up cancellation sensitivity analysis ‐ Normoresponders (micronised progesterone 200 mg versus GnRH antagonists) ‐ Own oocytes ‐ Early phase stimulation protocol ‐ Fresh embryo transfer Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 1 [0.33, 3.06] | 1 study · 114 participants | Ungraded |
Oocyte pick‐up cancellation sensitivity analysis ‐ PCOS (high‐responders)(micronised progesterone 100 mg versus GnRH antagonists) ‐ Own oocytes ‐ Early phase stimulation protocol ‐ Frozen embryo transfer Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 0.33 [0.01, 8.21] | 1 study · 120 participants | Ungraded |
Oocyte pick‐up cancellation sensitivity analysis ‐ total Summary of findings table ‐ Progestogens vs GnRH antagonists | OR 0.86 [0.4, 1.83] | 4 studies · 768 participants | Ungraded |
Summary of findings table ‐ Progestagen compared to GnRH agonist for assisted reproduction technology cycles
Population: assisted reproduction technology cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth or ongoing pregnancy Summary of findings table ‐ Progestagen vs GnRH agonist | OR 0.94 [0.58, 1.53] | 1 study · 260 participants | Low Downgraded: imprecision |
Oocyte pick‐up cancellation Summary of findings table ‐ Progestagen vs GnRH agonist | OR 1.36 [0.46, 4.02] | 1 study · 260 participants | Low Downgraded: imprecision |
Clinical Pregnancy Summary of findings table ‐ Progestagen vs GnRH agonist | OR 0.88 [0.54, 1.44] | 1 study · 260 participants | Low Downgraded: imprecision |
Miscarriage Summary of findings table ‐ Progestagen vs GnRH agonist | OR 0.49 [0.12, 2] | 1 study · 260 participants | Low Downgraded: imprecision |
MII oocytes Summary of findings table ‐ Progestagen vs GnRH agonist | no estimate extracted | 1 study · 260 participants | High |
Total dose of gonadotropins (IU) Summary of findings table ‐ Progestagen vs GnRH agonist | no estimate extracted | 1 study · 260 participants | High |
Moderate or severe OHSS Summary of findings table ‐ Progestagen vs GnRH agonist | OR 0.14 [0.01, 2.73] | 1 study · 260 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings table ‐ Progestogen 1 compared to Progestogen 2 for assisted reproduction technology cycles
Population: assisted reproduction technology cycles
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | no estimate extracted | 2 studies · 2 participants | Ungraded |
Oocyte pick‐up cancellation ‐ Normo‐responders (MPA 4 mg versus Micronised progesterone 100 mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 0.81 [0.43, 1.53] | 1 study · 300 participants | Low Downgraded: imprecision |
Oocyte pick‐up cancellation ‐ Normo‐responders (MPA 4 mg versus MPA 10 mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 2.27 [0.9, 5.74] | 1 study · 300 participants | Moderate Downgraded: imprecision |
Oocyte pick‐up cancellation ‐ Normo‐responders (MPA 4 mg versus Dydrogesterone 20 mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 1.19 [0.61, 2.34] | 1 study · 300 participants | Low Downgraded: imprecision |
Oocyte pick‐up cancellation ‐ Normo‐responders (MPA 10 mg versus Dydrogesterone 20 mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 1.49 [0.8, 2.8] | 1 study · 520 participants | Moderate Downgraded: imprecision |
Oocyte pick‐up cancellation ‐ Normo‐responders (Dydrogesterone 20 mg versus Micronised progesterone 100 mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 0.65 [0.4, 1.06] | 2 studies · 550 participants | Moderate Downgraded: imprecision |
Oocyte pick‐up cancellation ‐ Normo‐responders (Micronised progesterone 100 mg versus Micronised progesterone 200mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 0.35 [0.09, 1.37] | 1 study · 150 participants | Very low Downgraded: risk of bias, imprecision |
Clinical pregnancy ‐ Normo‐responders (MPA 10 mg versus Dydrogesterone 20 mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 1.11 [0.79, 1.57] | 1 study · 520 participants | Moderate Downgraded: imprecision |
Miscarriage ‐ Miscarriage per randomised woman ‐ Normo‐responders (MPA 10 mg versus Dydrogesterone 20 mg) ‐ Own oocytes ‐ Early phase stimulation protocol Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | OR 1.66 [0.68, 4.07] | 1 study · 520 participants | Low Downgraded: imprecision |
MII oocytes Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | no estimate extracted | 0 studies · 0 participants | Ungraded |
Total dose of gonadotropins Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | no estimate extracted | 0 studies · 0 participants | Ungraded |
Moderate or severe OHSS Summary of findings table ‐ Progestogen 1 vs Progestogen 2 | no estimate extracted | 0 studies · 0 participants | Ungraded |