title: Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy of luteal phase support with vaginal progesterone in women undergoing intrauterine insemination (IUI).
  
  
  METHODS
  Systematic review and meta-analysis. Randomized controlled trials (RCT) comparing supplementation of luteal phase with vaginal progesterone among women undergoing IUI versus a control group were included. The main outcome assessed was live birth rate.
  
  
  RESULTS
  Five RCT met the inclusion criteria. In all 1,271 patients were included (951 IUI cycles in the progesterone group, 935 in the control group). Women treated with vaginal progesterone achieved significantly higher live birth rate (risk ratio [RR] 1.94, 95 % confidence interval [CI] 1.36 to 2.77,), and clinical pregnancy rate (RR 1.41, 95 % CI 1.14 to 1.76) as compared with controls. In the subgroup analysis per stimulation protocol, this beneficial effect of receiving progesterone was only observed in the group stimulated with gonadotropins (RR 2.28, 95 % CI 1.49 to 3.51), compared to the group stimulated with clomiphene citrate (CC) (RR 1.30, 95 % CI 0.68 to 2.50). No differences were observed in the miscarriage and multiple pregnancy rates.
  
  
  CONCLUSIONS
  The supplementation of luteal phase with vaginal progesterone significantly increases live birth among women undergoing IUI when receiving gonadotropins for ovulation induction. Women receiving CC to induce ovulation do not seem to benefit from this treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain, emiralpeix@parcdesalutmar.cat.
authors.forename: Ester
authors.initials: E
authors.lastname: Miralpeix
authors.forename: Mireia
authors.initials: M
authors.lastname: González-Comadran
authors.forename: Ivan
authors.initials: I
authors.lastname: Solà
authors.forename: Dolors
authors.initials: D
authors.lastname: Manau
authors.forename: Ramon
authors.initials: R
authors.lastname: Carreras
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Checa
mesh_terms: D000282:Administration, Intravaginal; D005260:Female; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007315:Insemination, Artificial / Q000379:methods*; D008183:Luteal Phase / Q000187:drug effects*; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D011374:Progesterone