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Luteal phase support in in vitro fertilization: meta-analysis of randomized trials
Saleema Nosarka1, Thinus Kruger, Igno Siebert
1Department of Obstetrics and Gynaecology, Stellenbosch University, Tygerberg, South Africa. hkr@sun.ac.za
Objective:
To determine if luteal phase support improves the pregnancy rate in in vitro fertilization (IVF) cycles.
Design:
A meta-analysis of randomized trials of luteal phase support was carried out with the main outcome measure being the pregnancy rate per cycle.
Results:
Fifty-nine trials were evaluated. Eighteen trials met the inclusion criteria. Five main themes were identified: human chorionic gonadotropin (hCG) versus progesterone; progesterone versus progesterone and hCG; progesterone versus placebo; hCG versus placebo, and hCG versus progesterone versus no support.
Conclusion:
Luteal phase support is definitely indicated in IVF treatment cycles. This meta-analysis favored hCG above progesterone as luteal phase support with respect to pregnancy rates. Further prospective randomized trials are needed to determine a definite consensus with respect to the duration of luteal phase support in IVF cycles.
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