The majority of controlled superovulation procedures for in vitro fertilization-embryo transfer treatment are performed with a long regimen of gonadotropin-releasing hormone agonist (GnRH-a) for descending regulation; GnRH-a suppresses endogenous LH peaks through descending regulation of the pituitary gland, but may produce sustained inhibition of pituitary function, affecting luteal function and directly affecting endometrial tolerance; loss of granulosa cells during follicular aspiration during egg retrieval can also lead to impaired luteal phase function and pregnancy rates. The loss of granulosa cells during follicular aspiration may impair the secretion of estrogen and progesterone from the granulosa luteal cells, which may also lead to luteal insufficiency, resulting in lower embryo implantation and pregnancy rates. luteal support after IVF with medications to promote or supplement luteal function may improve the patient’s luteal insufficiency and increase embryo implantation and pregnancy rates accordingly. Luteal support is most often started on the day of egg retrieval; if pregnancy occurs, treatment is continued until clinical pregnancy is confirmed or the placenta is autonomously functioning. Progesterone is the basic medication for luteal support treatment, and there are three main routes of administration: intramuscular injection, oral and transvaginal. 1, intramuscular injection: intramuscular injection of progesterone injection is economical and efficient, and is currently the most commonly used mode of clinical administration. Intramuscular injection of progesterone can increase serum progesterone concentration during the luteal phase, improve luteal function, increase embryo implantation rate and pregnancy rate, improve IVF outcome, and have definite efficacy. However, there is no uniform standard for the minimum effective dose so far, and the dose of progesterone applied in different centers of luteal support varies greatly, from 20mg/d to 120mg/d. Long-term intramuscular progesterone oil injection can cause pain, redness, swelling, hard nodules, inflammatory reactions and metaplasia at the injection site affecting drug absorption. 2, oral: oral progesterone is a relatively simple way, and avoid the redness and swelling and other local adverse reactions that may be caused by intramuscular injection. The degradation products of oral progesterone metabolism can produce side effects such as drowsiness, dizziness, flushing of the face, and increased secretion of stomach acid. To date, no teratogenic effects have been found in independent trials of oral progesterone drugs, and birth defects have not been reported in birth-controlled children, but large samples of randomized controlled trials are still needed to confirm the efficacy and safety of oral progesterone luteal support. The main oral progesterone available for IVF luteal support are: Angiotensin Progesterone Capsules, 200-300 mg/d in 1 dose or 3 doses. The dose of each dose should not exceed 200mg; Didrogestrel tablets, 20-30mg/d, 1 time or in 2 doses, each dose should not exceed 20mg (Imaxin progesterone capsules 200-300mg/d, 1 time or in 2 doses. Each dose should not exceed 200mg; Kine Progesterone Capsules, 200-300mg/d, 1 time or divided into 2 doses. Each dose should not exceed 200mg. 3. Transvaginal administration: After transvaginal administration, the drug is rapidly absorbed, without liver first-pass effect, and the drug action directly reaches the uterus, increasing the local progesterone concentration in the endometrial tissue and exerting local endothelial effect with minimal systemic adverse effects. The vast majority of studies have shown that transvaginal progesterone is more effective than oral administration; more studies have shown that it also has certain advantages compared with intramuscular injection. Transvaginal administration is convenient, effective, and may be a trend for the future. Progesterone preparations that can be administered via the vaginal route include progesterone vaginal extended-release gel, progesterone capsules, natural progesterone suppositories, and progesterone vaginal rings. In addition, depending on individual circumstances, progesterone supplementation can be administered by a combination of two routes, such as: intramuscular plus oral, intramuscular plus vaginal administration, and oral plus vaginal route. II. Estrogen supplementation in addition to progesterone supplementation Estrogen is needed for luteal support during assisted reproduction in women with absent or dysfunctional ovaries undergoing egg donor embryo transfer cycles. In addition to this, it is still controversial whether estrogen supplementation improves pregnancy rates, and whether estrogen should be added during the luteal phase is still being explored. The results of the current meta-analysis conclude that the available evidence is not yet sufficient to prove that the addition of estrogen to luteal support after IVF is beneficial. Whether the addition of estrogen to luteal support in the IVF cycle is effective may be related to the dose of E2, the route and or the protocol of IVF superovulation. The main estrogens currently available for post-IVF luteal support are estradiol valerate (supplemental Glaxo), micronized 17β estradiol (Nokunflu), and 17β estradiol transdermal absorption formulation (Estro Gel). It is more commonly used clinically to add oral supplementation of progesterone with 1-3 capsules 1-3 times a day. Third, HCG supplementation Intramuscular injection of HCG promotes the conversion of androgen aromatization to estrogen and prolongation of luteal life, stimulates the continuous secretion of estrogen and progesterone in somatic granulosa cells, and secondly, it can also stimulate the secretion of other luteal products that have not yet been clearly influenced by implantation and enhance the function of the corpus luteum. However, because luteal support with HCG can increase the incidence of ovarian hyperstimulation syndrome, its clinical application is somewhat limited and is generally used in ovarian hyporesponsive patients with low E2 levels. In luteal support after IVF, it is mostly used in combination with progestin or in combination with estrogen and progestin, and the dose generally used is 1000-3000 IU two to three times a week. 1500 IU HCG injections can effectively support luteal function and avoid the occurrence of OHSS. IV. Other The role of GnRH-a in luteal support after IVF has also recently begun to receive attention. It has been reported that after induction of follicular maturation with 200ug of buserelin, 100ug of buserelin was given three times daily for 15 days to support the corpus luteum, and the effect of luteal support was found to be comparable to that of the control measure (10,000 IU of HCG injection after induction of egg maturation, 200 mg of micronized progesterone given vaginally three times daily). Some studies have suggested that GnRH-a for luteal support may be more effective in regimens treated with GnRH-antagonists. However, information on the clinical use of GnRH-a in IVF luteal support is scarce to date, and more studies are needed to provide evidence for clinical use. In conclusion, progestogen supplementation is currently the most commonly used luteal support regimen in IVF treatment. Clinical application should be based on a comprehensive assessment of the patient’s ovulation protocol, follicle count, E2 level, age and other factors to develop a reasonable and individualized protocol to minimize unnecessary pharmacological interventions and achieve a safer and more effective luteal phase support.