Progesterone-releasing vaginal ring for luteal phase support after superovulation and intrauterine insemination cycles, a pilot study

Abstract

Objective: The main objective of this pilot study was to determine whether a progesterone-releasing vaginal ring is a good alternative for luteal phase support for patients undergoing intrauterine insemination after ovulation induction with sc gonadotrophins. material and methods: We performed a multi-center study involving three different reproductive medicine units. Patients included were diagnosed with unexplained infertility rFSH (Puregon ®) and ovulation induction with urinary HCG (Pregnyl ®). The day of insemination patients were randomized to receive luteal phase supplementation with progesterone vaginal ring (Fertiring ®) or no supplementation.

The efficacy and safety of luteal phase support with progesterone following ovarian stimulation and intrauterine insemination: A systematic review and meta-analysis

“…We assessed whether our results would change by including only studies with a moderate to low risk of bias. Excluding studies deemed to be at high risk of bias (19,24,43) from our syntheses yielded comparable effect estimates that were the same, or larger than those obtained from the analysis of all included studies. In order to test whether the results of our meta-analysis did not depend on our model choice, we performed a sensitivity analysis using DerSimonian-Laird estimators without Hartung-Knapp adjustments in random effects models for the syntheses of the main outcomes.…”

“…We identified fifteen published RCTs comparing progesterone luteal phase support after OS-IUI to placebo or no intervention which reported the outcomes of interest (9,19,24,25,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). With respect to the previous review by Green et al, we identified three additional studies (36,43,45) that met the inclusion criteria specified by the authors but were not included in their review, and one newer study (39).For the present review, we had specified unexplained or mild male infertility as the population of interest; this led to the exclusion of the study by Yacizi et al (45), which included only women with PCOS. Our requirement that ITT, per participant data could be extracted resulted in exclusion of an additional two studies (36,42).…”

“…Two trials (25,41), were at overall low risk of bias. Three studies were found to be at high risk of bias: one (19) used sequential randomization; one (43) did not provide any details on the randomization process and the baseline table showed differences (younger age, younger partner age, shorter duration of infertility) that favoured the intervention group. Due to unclear or missing details on allocation sequence concealment or missing outcome data, the remaining seven studies were judged as "some concerns" (9, 25, 37-40, 44) (Figure 2B).…”

“…1 Excluded studies(19,24,43): RR, risk ratio; CI, confidence interval; PM, Paule-Mandel estimator for t 2 ; hakn, Hartung-Knapp correction; DL, DerSimonian-Laird estimator for t 2 ; RoB, risk of bias.…”

El anillo vaginal de progesterona como soporte de la fase lútea en fertilización in vitro

“…Pero en 153 pacientes receptoras de ovodonación, halló mejor TI (19,9% versus 11,6%, p = 0,006) y TEC (39,8% versus 28,6%, respectivamente) (17) . Otra experiencia del uso de AV en el SFL fue la realizada por Schwarze, en 2013, en parejas de inseminación intrauterina, encontrando mejores TEC en el grupo que utilizó AV, aunque sin diferencias estadísticamente significativas (19,1% en el grupo de AV y 11,3% en el grupo sin SFL) (19) .…”