title: Timing luteal support in assisted reproductive technology: a systematic review.
abstract: OBJECTIVE
  To summarize the available published randomized controlled trial data regarding timing of P supplementation during the luteal phase of patients undergoing assisted reproductive technology (ART).
  
  
  METHODS
  A systematic review.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Undergoing IVF.
  
  
  METHODS
  Different starting times of P for luteal support.
  
  
  METHODS
  Clinical pregnancy (PR) and live birth rates.
  
  
  RESULTS
  Five randomized controlled trials were identified that met inclusion criteria with a total of 872 patients. A planned meta-analysis was not performed because of a high degree of clinical heterogeneity with regard to the timing, dose, and route of P. Two studies compared P initiated before oocyte retrieval versus the day of oocyte retrieval and PRs were 5%-12% higher when starting P on the day of oocyte retrieval. One study compared starting P on day 6 after retrieval versus day 3, reporting a 16% decrease in pregnancy in the day 6 group. Trials comparing P start times on the day of oocyte retrieval versus 2 or 3 days after retrieval showed no significant differences in pregnancy.
  
  
  CONCLUSIONS
  There appears to be a window for P start time between the evening of oocyte retrieval and day 3 after oocyte retrieval. Although some studies have suggested a potential benefit in delaying vaginal P start time to 2 days after oocyte retrieval, this review could not find randomized controlled trials to adequately assess this. Further randomized clinical trials are needed to better define P start time for luteal support after ART.
authors: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors: Matthew T
authors: MT
authors: Connell
authors: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors: Jennifer M
authors: JM
authors: Szatkowski
authors: National Institutes of Health Library, Bethesda, Maryland.
authors: Nancy
authors: N
authors: Terry
authors: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors: Alan H
authors: AH
authors: DeCherney
authors: Texas Fertility Center, Austin, Texas.
authors: Anthony M
authors: AM
authors: Propst
authors: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: hillmicah@mail.nih.gov.
authors: Micah J
authors: MJ
authors: Hill
mesh_terms: D004334:Drug Administration Schedule; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000628:therapy*; D008183:Luteal Phase / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D027724:Reproductive Techniques, Assisted; D013997:Time Factors
chemical_list: D005300:Fertility Agents, Female; D011374:Progesterone
keywords: Progesterone; in vitro fertilization; luteal support
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