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{{Short description|Medication use in early pregnancy}}
'''Luteal support''' is the administration of medication, generally [[progesterone]], [[progestin]]s, [[Human chorionic gonadotropin|hCG]] or [[GnRH agonist]]s, to increase the success rate of [[Implantation (human embryo)|implantation]] and early [[Human embryogenesis|embryogenesis]], thereby complementing and/or supporting the function of the [[corpus luteum]]. It can be combined with for example [[in vitro fertilization]] and [[ovulation induction]].
'''Luteal support''' is the administration of medication, generally [[progesterone]], [[progestin]]s, [[Human chorionic gonadotropin|hCG]] or [[GnRH agonist]]s, to increase the success rate of [[Implantation (human embryo)|implantation]] and early [[Human embryogenesis|embryogenesis]], thereby complementing and/or supporting the function of the [[corpus luteum]]. It can be combined with for example [[in vitro fertilization]] and [[ovulation induction]].


Progesterone appears to be the best method of providing luteal phase support, with a relatively higher [[live birth rate]] than placebo, and a lower risk of [[ovarian hyperstimulation syndrome]] (OHSS) than [[Human chorionic gonadotropin|hCG]].<ref name="FarquharMarjoribanks2018">{{cite journal|last1=Farquhar|first1=Cindy|last2=Marjoribanks|first2=Jane|title=Assisted reproductive technology: an overview of Cochrane Reviews|journal=[[Cochrane review|Cochrane Database of Systematic Reviews]]|volume=8|pages=CD010537|year=2018|issn=1465-1858|doi=10.1002/14651858.CD010537.pub5|pmid=30117155|pmc=6513476}}</ref> Addition of other substances such as estrogen or hCG does not seem to improve outcomes.<ref name="FarquharMarjoribanks2018"/>
Progesterone appears to be the best method of providing luteal phase support, with a relatively higher [[live birth rate]] than placebo, and a lower risk of [[ovarian hyperstimulation syndrome]] (OHSS) than [[Human chorionic gonadotropin|hCG]].<ref name="FarquharMarjoribanks2018">{{cite journal|last1=Farquhar|first1=Cindy|last2=Marjoribanks|first2=Jane|title=Assisted reproductive technology: an overview of Cochrane Reviews|journal=[[Cochrane review|Cochrane Database of Systematic Reviews]]|volume=2018|pages=CD010537|year=2018|issue=8|issn=1465-1858|doi=10.1002/14651858.CD010537.pub5|pmid=30117155|pmc=6953328}}</ref> Addition of other substances such as estrogen or hCG does not seem to improve outcomes.<ref name="FarquharMarjoribanks2018"/>


==Progesterone and progestins==
==Progesterone and progestins==
The [[live birth rate]] is significantly higher with progesterone for luteal support in [[IVF]] cycles with or without [[intracytoplasmic sperm injection]] (ICSI).<ref name=van-der-Linden2011>{{Cite journal | last1 = Van Der Linden | first1 = M. | last2 = Buckingham | first2 = K. | last3 = Farquhar | first3 = C. | last4 = Kremer | first4 = J. A. M. | last5 = Metwally | first5 = M. | title = Luteal phase support in assisted reproduction cycles | doi = 10.1093/humupd/dms017 | journal = Human Reproduction Update | volume = 18 | issue = 5 | pages = 473 | year = 2012 | pmid = | pmc = | doi-access = free }}</ref><ref name="FarquharMarjoribanks2018"/> Co-treatment with [[GnRH agonist]]s further improves outcomes,<ref name="FarquharMarjoribanks2018"/> by a live birth rate [[risk difference|RD]] of +16% (95% [[confidence interval]] +10 to +22%).<ref>{{Cite journal | last1 = Kyrou | first1 = D. | last2 = Kolibianakis | first2 = E. M. | last3 = Fatemi | first3 = H. M. | last4 = Tarlatzi | first4 = T. B. | last5 = Devroey | first5 = P. | last6 = Tarlatzis | first6 = B. C. | title = Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: A systematic review and meta-analysis | journal = Human Reproduction Update | volume = 17 | issue = 6 | pages = 734–740 | year = 2011 | pmid = 21733980 | doi = 10.1093/humupd/dmr029| doi-access = free }}</ref>
The [[live birth rate]] is significantly higher with progesterone for luteal support in [[IVF]] cycles with or without [[intracytoplasmic sperm injection]] (ICSI).<ref name=van-der-Linden2011>{{Cite journal | last1 = Van Der Linden | first1 = M. | last2 = Buckingham | first2 = K. | last3 = Farquhar | first3 = C. | last4 = Kremer | first4 = J. A. M. | last5 = Metwally | first5 = M. | title = Luteal phase support in assisted reproduction cycles | doi = 10.1093/humupd/dms017 | journal = Human Reproduction Update | volume = 18 | issue = 5 | pages = 473 | year = 2012 | doi-access = free | hdl = 2066/98072 | hdl-access = free }}</ref><ref name="FarquharMarjoribanks2018"/> Co-treatment with [[GnRH agonist]]s further improves outcomes,<ref name="FarquharMarjoribanks2018"/> by a live birth rate [[risk difference|RD]] of +16% (95% [[confidence interval]] +10 to +22%).<ref>{{Cite journal | last1 = Kyrou | first1 = D. | last2 = Kolibianakis | first2 = E. M. | last3 = Fatemi | first3 = H. M. | last4 = Tarlatzi | first4 = T. B. | last5 = Devroey | first5 = P. | last6 = Tarlatzis | first6 = B. C. | title = Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: A systematic review and meta-analysis | journal = Human Reproduction Update | volume = 17 | issue = 6 | pages = 734–740 | year = 2011 | pmid = 21733980 | doi = 10.1093/humupd/dmr029| doi-access = free }}</ref>


===Routes and formulations===
===Routes and formulations===
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{|class="wikitable" align="right"
{|class="wikitable" align="right"
|+Oral formulations for luteal support
|+Oral formulations for luteal support
| [[Dydrogesterone]] || 10 mg 3 times daily,<ref name="BarbosaValadares2018"/> or<br>20 mg twice daily.<ref name="RashidiGhazizadeh2016">{{cite journal|last1=Rashidi|first1=Batool Hossein|last2=Ghazizadeh|first2=Mahya|last3=Tehrani Nejad|first3=Ensieh Shahrokh|last4=Bagheri|first4=Maryam|last5=Gorginzadeh|first5=Mansoureh|title=Oral dydrogesterone for luteal support in frozen-thawed embryo transfer artificial cycles: A pilot randomized controlled trial|journal=Asian Pacific Journal of Reproduction|volume=5|issue=6|year=2016|pages=490–494|issn=23050500|doi=10.1016/j.apjr.2016.10.002}}</ref>
| [[Dydrogesterone]] || 10&nbsp;mg 3 times daily,<ref name="BarbosaValadares2018"/> or<br/>20&nbsp;mg twice daily.<ref name="RashidiGhazizadeh2016">{{cite journal|last1=Rashidi|first1=Batool Hossein|last2=Ghazizadeh|first2=Mahya|last3=Tehrani Nejad|first3=Ensieh Shahrokh|last4=Bagheri|first4=Maryam|last5=Gorginzadeh|first5=Mansoureh|title=Oral dydrogesterone for luteal support in frozen-thawed embryo transfer artificial cycles: A pilot randomized controlled trial|journal=Asian Pacific Journal of Reproduction|volume=5|issue=6|year=2016|pages=490–494|issn=2305-0500|doi=10.1016/j.apjr.2016.10.002|doi-access=free}}</ref>
|-
|-
| [[Progesterone (medication)|Progesterone]] || 200mg, 3-4 times daily<ref>{{cite web|url=https://www.medscape.org/viewarticle/753218|title=Luteal Phase Progesterone Support in ART/IVF|author=Janelle Luk, MD; Pasquale Patrizio|website=Medscape|accessdate=2020-01-14}}</ref>
| [[Progesterone (medication)|Progesterone]] || 200&nbsp;mg, 3-4 times daily<ref name=Medscape>{{cite web|url=https://www.medscape.org/viewarticle/753218|title=Luteal Phase Progesterone Support in ART/IVF|author=Janelle Luk, MD|author2=Pasquale Patrizio|website=Medscape|access-date=2020-01-14}}</ref>
|-
| [[Desogestrel]] || 450μg once per day.<ref name="Wiweko2016"/>
|}
|}
*[[Oral administration|'''Oral''' administration]] of progesterone or progestin pills. Oral administration of progestins provides at least similar [[live birth rate]] than vaginal progesterone capsules when used for luteal support in [[embryo transfer]], with no evidence of increased risk of [[miscarriage]].<ref name="BarbosaValadares2018">{{cite journal|last1=Barbosa|first1=Marina Wanderley Paes|last2=Valadares|first2=Natália Paes Barbosa|last3=Barbosa|first3=Antônio César Paes|last4=Amaral|first4=Adelino Silva|last5=Iglesias|first5=José Rubens|last6=Nastri|first6=Carolina Oliveira|last7=Martins|first7=Wellington de Paula|last8=Nakagawa|first8=Hitomi Miura|title=Oral dydrogesterone vs. vaginal progesterone capsules for luteal-phase support in women undergoing embryo transfer: a systematic review and meta-analysis|journal=JBRA Assisted Reproduction|year=2018|issn=1518-0557|doi=10.5935/1518-0557.20180018|pmc=5982562}}</ref><ref name="GriesingerBlockeel2018">{{cite journal|last1=Griesinger|first1=Georg|last2=Blockeel|first2=Christophe|last3=T. Sukhikh|first3=Gennady|last4=Patki|first4=Ameet|last5=Dhorepatil|first5=Bharati|last6=Yang|first6=Dong-Zi|last7=Chen|first7=Zi-Jiang|last8=Kahler|first8=Elke|last9=Pexman-Fieth|first9=Claire|last10=Tournaye|first10=Herman|title=Oral dydrogesterone versus intravaginal micronized progesterone gel for luteal phase support in IVF: a randomized clinical trial|journal=Human Reproduction|year=2018|issn=0268-1161|doi=10.1093/humrep/dey306}}</ref>
*[[Oral administration|'''Oral''' administration]] of progesterone or progestin pills. Oral administration of progestins provides at least similar [[live birth rate]] than vaginal progesterone capsules when used for luteal support in [[embryo transfer]], with no evidence of increased risk of [[miscarriage]].<ref name="BarbosaValadares2018">{{cite journal|last1=Barbosa|first1=Marina Wanderley Paes|last2=Valadares|first2=Natália Paes Barbosa|last3=Barbosa|first3=Antônio César Paes|last4=Amaral|first4=Adelino Silva|last5=Iglesias|first5=José Rubens|last6=Nastri|first6=Carolina Oliveira|last7=Martins|first7=Wellington de Paula|last8=Nakagawa|first8=Hitomi Miura|title=Oral dydrogesterone vs. vaginal progesterone capsules for luteal-phase support in women undergoing embryo transfer: a systematic review and meta-analysis|journal=JBRA Assisted Reproduction|year=2018|issn=1518-0557|doi=10.5935/1518-0557.20180018|pmc=5982562|pmid=29488367|volume=22|issue=2|pages=148–156}}</ref><ref name="GriesingerBlockeel2018">{{cite journal|last1=Griesinger|first1=Georg|last2=Blockeel|first2=Christophe|last3=T. Sukhikh|first3=Gennady|last4=Patki|first4=Ameet|last5=Dhorepatil|first5=Bharati|last6=Yang|first6=Dong-Zi|last7=Chen|first7=Zi-Jiang|last8=Kahler|first8=Elke|last9=Pexman-Fieth|first9=Claire|last10=Tournaye|first10=Herman|title=Oral dydrogesterone versus intravaginal micronized progesterone gel for luteal phase support in IVF: a randomized clinical trial|journal=Human Reproduction|year=2018|volume=33|issue=12|pages=2212–2221|issn=0268-1161|doi=10.1093/humrep/dey306|pmid=30304457|pmc=6238366|doi-access=free}}</ref>
*[[Intravaginal administration|'''Intravaginal''' administration]] of gel, tablets or other inserts, such as [[endometrin]]. This was the most commonly used medication for luteal support in an Israeli survey in 2013, used without adjunctive medication in 77% of cases, mainly as tablets.<ref name="Vaisbuchde Ziegler2014">{{cite journal|last1=Vaisbuch|first1=Edi|last2=de Ziegler|first2=Dominique|last3=Leong|first3=Milton|last4=Weissman|first4=Ariel|last5=Shoham|first5=Zeev|title=Luteal-phase support in assisted reproduction treatment: real-life practices reported worldwide by an updated website-based survey|journal=Reproductive BioMedicine Online|volume=28|issue=3|year=2014|pages=330–335|issn=1472-6483|doi=10.1016/j.rbmo.2013.10.022|pmid=24447959|doi-access=free}}</ref>
*[[Intravaginal administration|'''Intravaginal''' administration]] of gel, tablets or other inserts, such as [[endometrin]]. A weekly [[vaginal ring]] is an effective and safe method for intravaginal administration.<ref name="StadtmauerWaud2014">{{cite journal|last1=Stadtmauer|first1=Laurel|last2=Waud|first2=Kay|title=Progesterone Vaginal Ring for Luteal Support|journal=The Journal of Obstetrics and Gynecology of India|volume=65|issue=1|year=2014|pages=5–10|issn=0971-9202|doi=10.1007/s13224-014-0634-0|pmid=25737615|pmc=4342373}}</ref>
*[[Intramuscular administration|'''Intramuscular''' administration]]. While daily intramuscular injections of progesterone-in-oil (PIO) have been the standard route of administration, PIO injections are not FDA-approved for use in pregnancy.
*[[Intramuscular administration|'''Intramuscular''' administration]]. Daily intramuscular injections of progesterone-in-oil (PIO) have been the standard route of administration,<ref name=Medscape/> but are not FDA-approved for use in pregnancy.


===Time of initiation===
===Time of initiation===
The time for beginning luteal support can be put in relation to various events:
The time for beginning luteal support can be put in relation to various events:
*In [[in vitro fertilization|IVF]], generally somewhere between the evening of [[oocyte retrieval]] and day 3 after oocyte retrieval, with weak evidence indicating that 2 days after oocyte retrieval may be optimal.<ref name="pmid25638420">{{cite journal|vauthors=Connell MT, Szatkowski JM, Terry N, DeCherney AH, Propst AM, Hill MJ | title=Timing luteal support in assisted reproductive technology: a systematic review. | journal=Fertil Steril | year= 2015 | volume= 103 | issue= 4 | pages= 939–946.e3 | pmid=25638420 | doi=10.1016/j.fertnstert.2014.12.125 | pmc=4385437 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25638420 }}</ref>
*In [[in vitro fertilization|IVF]], generally somewhere between the evening of [[oocyte retrieval]] and day 3 after oocyte retrieval, with weak evidence indicating that 2 days after oocyte retrieval may be optimal.<ref name="pmid25638420">{{cite journal|vauthors=Connell MT, Szatkowski JM, Terry N, DeCherney AH, Propst AM, Hill MJ | title=Timing luteal support in assisted reproductive technology: a systematic review. | journal=Fertil Steril | year= 2015 | volume= 103 | issue= 4 | pages= 939–946.e3 | pmid=25638420 | doi=10.1016/j.fertnstert.2014.12.125 | pmc=4385437 }}</ref>
*In [[artificial insemination]], luteal support is generally started on the day of insemination, or the day after.<ref name="GreenZolton2017">{{cite journal|last1=Green|first1=Katherine A.|last2=Zolton|first2=Jessica R.|last3=Schermerhorn|first3=Sophia M.V.|last4=Lewis|first4=Terrence D.|last5=Healy|first5=Mae W.|last6=Terry|first6=Nancy|last7=DeCherney|first7=Alan H.|last8=Hill|first8=Micah J.|title=Progesterone luteal support after ovulation induction and intrauterine insemination: an updated systematic review and meta-analysis|journal=Fertility and Sterility|volume=107|issue=4|year=2017|pages=924–933.e5|issn=00150282|doi=10.1016/j.fertnstert.2017.01.011}}</ref>
*In [[artificial insemination]], luteal support is generally started on the day of insemination, or 1 to 2 days after.<ref name="GreenZolton2017">{{cite journal|last1=Green|first1=Katherine A.|last2=Zolton|first2=Jessica R.|last3=Schermerhorn|first3=Sophia M.V.|last4=Lewis|first4=Terrence D.|last5=Healy|first5=Mae W.|last6=Terry|first6=Nancy|last7=DeCherney|first7=Alan H.|last8=Hill|first8=Micah J.|title=Progesterone luteal support after ovulation induction and intrauterine insemination: an updated systematic review and meta-analysis|journal=Fertility and Sterility|volume=107|issue=4|year=2017|pages=924–933.e5|issn=0015-0282|doi=10.1016/j.fertnstert.2017.01.011|pmid=28238492|doi-access=free}}</ref>


===Duration===
===Duration===
Luteal support given for a shorter duration than 7 weeks results in an increased risk of miscarriage in women with a dysfunctional [[corpus luteum]] (as can be diagnosed by [[blood test]]s for endogenous progesterone).<ref name="LienJou2015">{{cite journal|last1=Lien|first1=Y.R.|last2=Jou|first2=G.|last3=Yang|first3=P.|last4=Chen|first4=S.|title=The duration of luteal phase support by progesterone in fresh transfer cycles can be determined by corpus luteum rescue or not|journal=Fertility and Sterility|volume=104|issue=3|year=2015|pages=e344–e345|issn=0015-0282|doi=10.1016/j.fertnstert.2015.07.1074}}</ref> In general, however, luteal support can safely be discontinued at the time of a positive [[pregnancy test]] (approximately 2 weeks after fertilization).<ref name="Wiweko2016">{{cite journal|last1=Wiweko|first1=Budi|title=Luteal Phase Support in Controlled Ovarian Hyperstimulation|year=2016|pages=135–144|doi=10.1007/978-81-322-1121-1_11|journal=Springer|url=https://books.google.se/books?id=_I6QCgAAQBAJ&pg=PA135}}</ref>
Luteal support given for a shorter duration than 7 weeks results in an increased risk of miscarriage in women with a dysfunctional [[corpus luteum]] (as can be diagnosed by [[blood test]]s for endogenous progesterone).<ref name="LienJou2015">{{cite journal|last1=Lien|first1=Y.R.|last2=Jou|first2=G.|last3=Yang|first3=P.|last4=Chen|first4=S.|title=The duration of luteal phase support by progesterone in fresh transfer cycles can be determined by corpus luteum rescue or not|journal=Fertility and Sterility|volume=104|issue=3|year=2015|pages=e344–e345|issn=0015-0282|doi=10.1016/j.fertnstert.2015.07.1074|doi-access=free}}</ref> In general, however, luteal support can safely be discontinued at the time of a positive [[pregnancy test]] (approximately 2 weeks after fertilization).<ref name="Wiweko2016">{{cite book|last1=Wiweko|first1=Budi|title=Ovarian Stimulation Protocols|chapter=Luteal Phase Support in Controlled Ovarian Hyperstimulation|year=2016|pages=135–144|doi=10.1007/978-81-322-1121-1_11|publisher=Springer|isbn=978-81-322-1120-4|chapter-url=https://books.google.com/books?id=_I6QCgAAQBAJ&pg=PA135}}</ref>


==Other substances tested in luteal phase==
==Other substances tested in luteal phase==
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==References==
==References==
{{reflist}}
{{Reflist}}


[[Category:Assisted reproductive technology]]
[[Category:Assisted reproductive technology]]

Latest revision as of 04:03, 6 January 2024

Luteal support is the administration of medication, generally progesterone, progestins, hCG or GnRH agonists, to increase the success rate of implantation and early embryogenesis, thereby complementing and/or supporting the function of the corpus luteum. It can be combined with for example in vitro fertilization and ovulation induction.

Progesterone appears to be the best method of providing luteal phase support, with a relatively higher live birth rate than placebo, and a lower risk of ovarian hyperstimulation syndrome (OHSS) than hCG.[1] Addition of other substances such as estrogen or hCG does not seem to improve outcomes.[1]

Progesterone and progestins

[edit]

The live birth rate is significantly higher with progesterone for luteal support in IVF cycles with or without intracytoplasmic sperm injection (ICSI).[2][1] Co-treatment with GnRH agonists further improves outcomes,[1] by a live birth rate RD of +16% (95% confidence interval +10 to +22%).[3]

Routes and formulations

[edit]

There is no evidence of any route of administration of progesterone or progestins being more beneficial than others for luteal support.[1] The main ones are:

Oral formulations for luteal support
Dydrogesterone 10 mg 3 times daily,[4] or
20 mg twice daily.[5]
Progesterone 200 mg, 3-4 times daily[6]
Desogestrel 450μg once per day.[7]

Time of initiation

[edit]

The time for beginning luteal support can be put in relation to various events:

  • In IVF, generally somewhere between the evening of oocyte retrieval and day 3 after oocyte retrieval, with weak evidence indicating that 2 days after oocyte retrieval may be optimal.[10]
  • In artificial insemination, luteal support is generally started on the day of insemination, or 1 to 2 days after.[11]

Duration

[edit]

Luteal support given for a shorter duration than 7 weeks results in an increased risk of miscarriage in women with a dysfunctional corpus luteum (as can be diagnosed by blood tests for endogenous progesterone).[12] In general, however, luteal support can safely be discontinued at the time of a positive pregnancy test (approximately 2 weeks after fertilization).[7]

Other substances tested in luteal phase

[edit]

The addition of estrogen or hCG as adjunctives to progesterone do not appear to affect outcomes pregnancy rate and live birth rate in IVF.[1] In fact, luteal support with human chorionic gonadotropin (hCG) alone or as a supplement to progesterone has been associated with a higher risk of ovarian hyperstimulation syndrome (OHSS).[2] Low molecular weight heparin as luteal support may improve the live birth rate but has substantial side effects and has no reliable data on long-term effects.[1] Glucocorticoids such as cortisol has limited evidence of efficacy as luteal support.[1]

References

[edit]
  1. ^ a b c d e f g h Farquhar, Cindy; Marjoribanks, Jane (2018). "Assisted reproductive technology: an overview of Cochrane Reviews". Cochrane Database of Systematic Reviews. 2018 (8): CD010537. doi:10.1002/14651858.CD010537.pub5. ISSN 1465-1858. PMC 6953328. PMID 30117155.
  2. ^ a b Van Der Linden, M.; Buckingham, K.; Farquhar, C.; Kremer, J. A. M.; Metwally, M. (2012). "Luteal phase support in assisted reproduction cycles". Human Reproduction Update. 18 (5): 473. doi:10.1093/humupd/dms017. hdl:2066/98072.
  3. ^ Kyrou, D.; Kolibianakis, E. M.; Fatemi, H. M.; Tarlatzi, T. B.; Devroey, P.; Tarlatzis, B. C. (2011). "Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: A systematic review and meta-analysis". Human Reproduction Update. 17 (6): 734–740. doi:10.1093/humupd/dmr029. PMID 21733980.
  4. ^ a b Barbosa, Marina Wanderley Paes; Valadares, Natália Paes Barbosa; Barbosa, Antônio César Paes; Amaral, Adelino Silva; Iglesias, José Rubens; Nastri, Carolina Oliveira; Martins, Wellington de Paula; Nakagawa, Hitomi Miura (2018). "Oral dydrogesterone vs. vaginal progesterone capsules for luteal-phase support in women undergoing embryo transfer: a systematic review and meta-analysis". JBRA Assisted Reproduction. 22 (2): 148–156. doi:10.5935/1518-0557.20180018. ISSN 1518-0557. PMC 5982562. PMID 29488367.
  5. ^ Rashidi, Batool Hossein; Ghazizadeh, Mahya; Tehrani Nejad, Ensieh Shahrokh; Bagheri, Maryam; Gorginzadeh, Mansoureh (2016). "Oral dydrogesterone for luteal support in frozen-thawed embryo transfer artificial cycles: A pilot randomized controlled trial". Asian Pacific Journal of Reproduction. 5 (6): 490–494. doi:10.1016/j.apjr.2016.10.002. ISSN 2305-0500.
  6. ^ a b Janelle Luk, MD; Pasquale Patrizio. "Luteal Phase Progesterone Support in ART/IVF". Medscape. Retrieved 2020-01-14.
  7. ^ a b Wiweko, Budi (2016). "Luteal Phase Support in Controlled Ovarian Hyperstimulation". Ovarian Stimulation Protocols. Springer. pp. 135–144. doi:10.1007/978-81-322-1121-1_11. ISBN 978-81-322-1120-4.
  8. ^ Griesinger, Georg; Blockeel, Christophe; T. Sukhikh, Gennady; Patki, Ameet; Dhorepatil, Bharati; Yang, Dong-Zi; Chen, Zi-Jiang; Kahler, Elke; Pexman-Fieth, Claire; Tournaye, Herman (2018). "Oral dydrogesterone versus intravaginal micronized progesterone gel for luteal phase support in IVF: a randomized clinical trial". Human Reproduction. 33 (12): 2212–2221. doi:10.1093/humrep/dey306. ISSN 0268-1161. PMC 6238366. PMID 30304457.
  9. ^ Stadtmauer, Laurel; Waud, Kay (2014). "Progesterone Vaginal Ring for Luteal Support". The Journal of Obstetrics and Gynecology of India. 65 (1): 5–10. doi:10.1007/s13224-014-0634-0. ISSN 0971-9202. PMC 4342373. PMID 25737615.
  10. ^ Connell MT, Szatkowski JM, Terry N, DeCherney AH, Propst AM, Hill MJ (2015). "Timing luteal support in assisted reproductive technology: a systematic review". Fertil Steril. 103 (4): 939–946.e3. doi:10.1016/j.fertnstert.2014.12.125. PMC 4385437. PMID 25638420.
  11. ^ Green, Katherine A.; Zolton, Jessica R.; Schermerhorn, Sophia M.V.; Lewis, Terrence D.; Healy, Mae W.; Terry, Nancy; DeCherney, Alan H.; Hill, Micah J. (2017). "Progesterone luteal support after ovulation induction and intrauterine insemination: an updated systematic review and meta-analysis". Fertility and Sterility. 107 (4): 924–933.e5. doi:10.1016/j.fertnstert.2017.01.011. ISSN 0015-0282. PMID 28238492.
  12. ^ Lien, Y.R.; Jou, G.; Yang, P.; Chen, S. (2015). "The duration of luteal phase support by progesterone in fresh transfer cycles can be determined by corpus luteum rescue or not". Fertility and Sterility. 104 (3): e344 – e345. doi:10.1016/j.fertnstert.2015.07.1074. ISSN 0015-0282.