Majid Vatankhah - Department of Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Arman Hakemi - Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Fatemeh Rahmanian - Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
Somayeh Hoseini - MSC in Midwifery Counseling, Jahrom University of Medical Sciences, Jahrom, Iran.
Samaneh Abiri - Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
Farideh Mogharab - Department of Obstetrics and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran
Lohrasb Taheri - Department of Surgery, Jahrom University of Medical Sciences, Jahrom, Iran.
Rezvan Heidari - Vice Chancellor for Health, Shiraz University of Medical Sciences, Shiraz, Iran
Marzieh Haghbeen - Women’s Health and Disease Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.

Background: The progesterone secreted from the ovary until the seventh week of pregnancy is required to maintain pregnancy. In fertility-assisted cycles, administration of GnRH agonists, can cause Corpus luteum failure and progesterone secreted from the ovary will not be sufficient to protect pregnancy. The best way to prevent this situation is support progesterone administration. Objective: this study aimed to rank the best route of progesterone administration in luteal phase support. Methods: Randomized controlled trials (RCTs) of progesterone for the luteal phase support were identified from online databases of Scopus, Google Scholar, Pubmed. Treatment efficacy was defined as ongoing pregnancy.  Data were extracted and analyzed using odds ratios (ORs). A Bayesian network meta-analysis was performed using the Markov chain Monte Carlo method in WinBUGS and NetMetaXL. Results: Total ۱۱۷۶ participants were studied in ۱۶ trials of ۶ separate progesterone routes including vaginal progesterone gel, progesterone sub q, Dydrogesterone, Cap ۲۰۰ mg TID, Cap ۲۰۰ mg BID, and progesterone IM. Comparison test shows better likelihood of SUCRA followed by vaginal progesterone gel (۷۷.۸%), progesterone sub q (۵۵.۴۹%), Dydrogesterone (۵۳.۹۷%), Cap ۲۰۰ mg TID (۵۰.۶۷%), Cap ۲۰۰ mg BID (۴۸.۹۹%) and finally progesterone IM (۱۳.۰۶%). Conclusion: This study ranked as the best route of progesterone therapy for luteal phase support, through the reviewed studies.

Network meta-analysis, Progesterone, Luteal Phase Support, IVF.