Vaginal progesterone gel for luteal phase support in IVF/ICSI cycles: a meta-analysis

Objective: To investigate whether vaginal progesterone gel may result in similar or higher pregnancy rates compared with all other vaginal progesterone forms when used for luteal-phase support. Design: Meta-analysis of randomized controlled trials using odds ratios (OR) and 95% confidence intervals (CI). Patient(s): Infertile women undergoing IVF or ICSI. Intervention(s): Vaginal progesterone gel 90mg once or twice daily versus any other vaginal progesterone form for luteal phase support. Main Outcome Measure(s): Clinical pregnancy rates. Result(s): Seven randomized controlled trials, involving 2,447 patients, were included in the analysis. No difference was observed in the overall clinical pregnancy rate when comparing vaginal progesterone gel with any other vaginal progesterone form. Moreover, clinical pregnancy rates were similar in protocols using only GnRH agonists and when comparing vaginal gel with the traditional treatment of 200 mg x 3 vaginal progesterone capsules. Conclusion(s): This meta-analysis provides solid evidence that no significant difference exists between vaginal gel and all other vaginal progesterone forms in terms of clinical pregnancy rates. (Fertil Steril (R) 2010; 94: 2083-7. (C) 2010 by American Society for Reproductive Medicine.