{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T11:51:14Z","timestamp":1792324274134,"version":"4.4.0"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare reproductive outcome between luteal\u2010phase support (LPS) protocols for frozen embryo transfer (FET) cycles with hormone replacement therapy (HRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A search was conducted in MEDLINE, Scopus, LILACS, EMBASE, Scielo.br, PROSPERO, CINAHL, PsycINFO, AMED,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      , ICTRP, the Cochrane Library and conference proceedings, with no restrictions on date, geography or language. We included all randomized controlled trials (RCTs) that allocated infertile women to at least two different hormone\u2010based LPS protocols for HRT\u2013FET, with similar baseline characteristics between groups. The Preferred Reporting Items for Systematic reviews and Meta\u2010Analyses extension statement for network meta\u2010analyses (PRISMA\u2010NMA) was followed. A random\u2010effects network meta\u2010analysis was performed for direct and indirect pairwise comparisons to rank available LPS protocols by the surface under the cumulative ranking curve area (SUCRA). Risk of bias was assessed using the Cochrane risk\u2010of\u2010bias tool version 1. Certainty of evidence was evaluated using the Confidence in Network Meta\u2010Analysis (CINeMA) criteria. The primary outcomes were the live birth rate and the combined rate of ongoing pregnancy and live birth; the secondary outcomes were the clinical pregnancy rate and the pregnancy loss rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten RCTs assigned a total of 4216 patients to nine different LPS approaches. Regarding the combined outcome of ongoing pregnancy and live birth, oral dydrogesterone (DYD) combined with gonadotropin\u2010releasing hormone agonist (GnRHa) was significantly more efficacious compared with all other LPS protocols (very low to low certainty of evidence), with SUCRA analysis ranking it as the treatment of choice (SUCRA\u2009=\u200997.3%). When the analysis was restricted to live birth only, vaginal suppository progesterone showed a higher likelihood of being the treatment of choice (SUCRA\u2009=\u200989.7%), but only exhibited a significant difference on pairwise analysis when compared with intramuscular progesterone (odds ratio (OR), 0.53 (95%\u2009CI, 0.33\u20130.84); low certainty of evidence) and intramuscular progesterone\u2009+\u2009vaginal suppository progesterone (OR, 0.47 (95%\u2009CI, 0.32\u20130.69); low certainty of evidence). For the clinical pregnancy rate, no significant differences between treatments were found (very low to low certainty of evidence), with vaginal suppository progesterone + human chorionic gonadotropin being the highest\u2010ranked treatment (SUCRA\u2009=\u200933.7%). For pregnancy loss rate, intramuscular progesterone\u2009+\u2009vaginal suppository progesterone was significantly more efficacious compared with either treatment alone (low certainty of evidence), and had the highest chance of being the top\u2010ranked treatment (SUCRA\u2009=\u200951.4%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      There is very\u2010low\u2010to\u2010low\u2010certainty evidence that oral DYD\u2009+\u2009GnRHa and vaginal suppository progesterone alone could be the most promising LPS approaches to increase the rates of live birth and ongoing pregnancy in women undergoing HRT\u2013FET. However, the low certainty of evidence and the lack of a clear first\u2010ranked treatment, due to inconsistencies in the analysis for some outcomes, stress the need for further RCTs on this subject. \u00a9 2025 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.29302","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T09:34:13Z","timestamp":1754040853000},"page":"422-432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Reproductive outcome after frozen embryo transfer with hormone replacement therapy according to luteal\u2010phase support protocol: systematic review and network meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7414-4224","authenticated-orcid":false,"given":"A.","family":"Etrusco","sequence":"first","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) University of Palermo  Palermo Italy"},{"name":"Unit of Obstetrics and Gynecology, \u2018Paolo Giaccone\u2019 Hospital  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1106-3747","authenticated-orcid":false,"given":"B.","family":"Ata","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ko\u00e7 University School of Medicine  Istanbul T\u00fcrkiye"},{"name":"ART Fertility Clinics  Dubai United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Agrifoglio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) University of Palermo  Palermo Italy"},{"name":"Unit of Obstetrics and Gynecology, \u2018Paolo Giaccone\u2019 Hospital  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"D'Amato","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine (DIM), Unit of Obstetrics and Gynecology University of Bari \u2018Aldo Moro\u2019, Policlinico of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Wyns","sequence":"additional","affiliation":[{"name":"Cliniques Universitaires Saint\u2010Luc Universit\u00e9 Catholique de Louvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2824-5435","authenticated-orcid":false,"given":"A.","family":"Vitagliano","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine (DIM), Unit of Obstetrics and Gynecology University of Bari \u2018Aldo Moro\u2019, Policlinico of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Alviggi","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Naples Federico II  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Conforti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Science and Odontostomatology University of Naples Federico II  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Favilli","sequence":"additional","affiliation":[{"name":"Section of Obstetrics and Gynecology, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"De Franciscis","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and General and Specialized Surgery University of Campania \u2018Luigi Vanvitelli\u2019  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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