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Human Reproduction, Vol. 15, No. suppl_1, pp. 129-148, 2000
© 2000 European Society of Human Reproduction and Embryology

Progesterone for the luteal support of assisted reproductive technologies: clinical options

Cemal Posaci1,2, Johan Smitz1, Michel Camus1, Kaan Osmanagaoglu1 and Paul Devroey1,3

1 Centre for Reproductive Medicine, Dutch-speaking Brussels Free University Laarbeeklaan 101 B 1090 Brussels, Belgium 2 Dokuz Eylul Universitesi Tip Fakultesi, Kadin Hastaliklari ve Dogum Anabilim Dali Inciralti 35350 Izmir, Turkey

Correspondence: 3To whom correspondence should be addressed

The role of progesterone in luteal support in assisted reproductive technologies (ART) is reviewed. There is insufficient data in ART treatment without gonadotrophin-releasing hormone (GnRH) analogues, to prove the necessity for luteal phase support using progesterone. Prospective studies have shown that ART cycles using GnRH analogues need to be supplemented. GnRH antagonists could have some adverse effects on the luteal phase. So far, no prospective randomized comparative study has been performed to investigate the necessity for luteal phase support when antagonists are used in ART cycles. Clinical outcome data (pregnancy and abortion rates) show similar success rates for human chorionic gonadotrophin (HCG) or progesterone supplementation. A major disadvantage of using HCG is the risk of maintaining or enhancing ovarian hyperstimulation syndrome. Of the several routes of administration of progesterone, the vaginal route is preferred because of its ease of use, reduced side-effects and, most importantly, the first uterine pass effect.

Key words: ART/luteal support/progesterone/route of administration


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