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

The role of progesterone in luteal support in assisted reproductive technol ogies (ART) is reviewed, There is insufficient data in ART treatment withou t 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 antagon ists could have some adverse effects on the luteal phase, So far, no prospe ctive randomized comparative study has been performed to investigate the ne cessity for luteal phase support when antagonists are used in ART cycles. C linical outcome data (pregnancy and abortion rates) show similar success ra tes 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 .