evaluation of various progesterone therapy routes for luteal phase support in ivf: a systematic review and meta-analysis

Background:the progesterone secreted from the ovary until the seventh week of pregnancy is required tomaintain pregnancy. in fertility-assisted cycles, administration of gnrh agonists can cause corpusluteum failure, and progesterone secreted from the ovary will not be sufficient to protect pregnancy.the best way to prevent this situation is to support progesterone administration.objective: this study aimed to rank the best route of progesterone administration in luteal phasesupport.methods:randomized controlled trials (rcts) of progesterone for the luteal phase support were identifiedfrom online databases of scopus, google scholar, pubmed. treatment efficacy was defined asongoing pregnancy. data were extracted and analyzed using odds ratios (ors). a bayesian networkmeta-analysis was performed using the markov chain monte carlo method in winbugs andnetmetaxl.results:total 1176 participants were studied in 16 trials of 6 separate progesterone routes including vaginalprogesterone gel, progesterone sub q, dydrogesterone, cap 200 mg tid, cap 200 mg bid, andprogesterone im. comparison test shows better likelihood of sucra followed by vaginalprogesterone gel (77.8%), progesterone sub q (55.49%), dydrogesterone (53.97%), cap 200 mg tid(50.67%), cap 200 mg bid (48.99%) and finally progesterone im (13.06%).conclusion:this study ranked as the best route of progesterone therapy for luteal phase support, through thereviewed studies.