title: Progesterone luteal support after ovulation induction and intrauterine insemination: an updated systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the effect of progesterone (P) for luteal phase support after ovulation induction (OI) and intrauterine insemination (IUI).
  
  
  METHODS
  An updated systematic review and meta-analysis.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Patients undergoing OI-IUI for infertility.
  
  
  METHODS
  Exogenous P luteal support after OI-IUI.
  
  
  METHODS
  Live birth.
  
  
  RESULTS
  Eleven trials were identified that met inclusion criteria and constituted 2,842 patients undergoing 4,065 cycles, more than doubling the sample size from the previous meta-analysis. In patients receiving gonadotropins for OI, clinical pregnancy (relative risk [RR] 1.56, 95% confidence interval [CI] 1.21-2.02) and live birth (RR 1.77, 95% CI 1.30-2.42) were more likely in P supplemented patients. These findings persisted in analysis of live birth per IUI cycle (RR 1.59, 95% CI 1.24-2.04). There were no data on live birth in clomiphene citrate or clomiphene plus gonadotropin cycles. There was no benefit on clinical pregnancy with P support for patients who underwent OI with clomiphene (RR 0.85, 95% CI 0.52-1.41) or clomiphene plus gonadotropins (RR 1.26, 95% CI 0.90-1.76).
  
  
  CONCLUSIONS
  Progesterone luteal phase support is beneficial to patients undergoing ovulation induction with gonadotropins in IUI cycles. The number needed to treat is 11 patients to have one additional live birth. Progesterone support did not benefit patients undergoing ovulation induction with clomiphene citrate or clomiphene plus gonadotropins.
authors.affiliation: 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: katherine.green@nih.gov.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Green
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Zolton
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Sophia M V
authors.initials: SM
authors.lastname: Schermerhorn
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Terrence D
authors.initials: TD
authors.lastname: Lewis
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Mae W
authors.initials: MW
authors.lastname: Healy
authors.affiliation: National Institutes of Health Library, Bethesda, Maryland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Terry
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
mesh_terms: D005260:Female; D005298:Fertility / Q000187:drug effects; D005299:Fertility Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006062:Gonadotropins / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007315:Insemination, Artificial / Q000009:adverse effects; D050498:Live Birth; D008183:Luteal Phase / Q000187:drug effects*; D016017:Odds Ratio; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005299:Fertility Agents; D006062:Gonadotropins; D011374:Progesterone
keywords: Intrauterine insemination; live birth; luteal support; ovulation induction; progesterone