Table 4.

Evidence-based recommendations for use of progesterone on fresh embryo transfer, including in patients with natural and modified cycles.

Evidence-based recommendations
Progesterone for fresh embryo transfer	Luteal phase support should commence within 3 days of oocyte retrieval [3] Progesterone can be given by any route, including oral dydrogesterone (10 mg, three times daily), or vaginal micronized progesterone (200 mg, three times daily) [59] The above regimen should continue until the pregnancy reaches 20 weeks of gestation [22]
Progesterone for natural/modified cycle frozen-thawed embryo transfer	Luteal phase support should be provided 3 days after the LH surge [66] Options include vaginal micronized progesterone tablets (400 mg, twice daily) or progesterone gel (90 mg, daily) [62,63]
Progesterone for programmed cycles of frozen-thawed embryo transfer	The options include vaginal micronized progesterone (400 mg, twice daily) and oral dydrogesterone (20 mg, twice daily) [69] Blood is sampled to measure progesterone levels. If the progesterone level is <10.6 ng/ml, progesterone is given by intramuscular injection (40 mg) [54] Or, water-soluble progesterone can be given by subcutaneous injection (25 mg) [55]