Progestogen Supplementation during Luteal Phase in the Treatment of Infertility in the First Trimester

Aim: The aim of present review is to provide a comprehensive view of the literature regarding the clinical efficacy and safety effects of supplementation of Progestogens during luteal phase in the first trimester. Methods: A literature search was performed using electronic databases like Pub med/Medline to identify from 1980 to 2015. The search yielded around 27 original studies and review articles. The search yielded around 31 clinical studies and reviews. Results: Progestogen use for luteal support in assisted reproductive technologies is associated with significantly higher rates of live birth or ongoing pregnancy than placebo or no treatment. Based on findings from randomized control studies and meta-analysis, similar ongoing pregnancy and miscarriage rates have been observed for dydrogesterone (oral) when compared to intra-vaginal micronized progesterone (MCP) and between MCP intra-vaginal and MCP intra-muscular for luteal phase support. However, dydrogesterone (oral) exhibited an overall higher ongoing pregnancy rate compared to MCP oral (30% vs. 11%). There was no evidence to indicate that maternal exposure to Progestogens during pregnancy increased the risk for birth defects. Conclusion: The relative effectiveness, safety, optimal route and duration of oral, vaginal, and intra-muscular progestogen formulations is a topic of ongoing debate. Future investigations with longer follow-ups and larger sample sizes comparing different routes of administration, dosages, and timing of administration are warranted.