Oral versus intramuscular progesterone for in vitro fertilization: a prospective randomized study.
OBJECTIVE
To evaluate the efficacy of oral micronized progesterone compared with IM progesterone in oil for luteal support in patients undergoing IVF who are treated with a GnRH agonist.


METHODS
Randomized prospective clinical trial.


METHODS
University-based IVF center.


METHODS
Women <40 years of age who were undergoing IVF with luteal GnRH pituitary down-regulation.


METHODS
Patients were randomized to receive either oral micronized progesterone (200 mg three times daily) or IM progesterone (50 mg daily).


METHODS
Progesterone levels at standardized days 21 and 28, and pregnancy and embryo implantation rates.


RESULTS
Day 21 progesterone levels were 77.6+/-13.2 ng/mL in the IM group and 81.5+/-16.2 ng/mL in the oral group. Day 28 progesterone levels were 76.3+/-15.0 ng/mL in the IM group and 53.6+/-10.1 ng/mL in the oral group. The clinical pregnancy rates were 57.9% and 45.8% for the IM and oral groups, respectively. The implantation rate per embryo was significantly higher in the IM group (40.9%) than in the oral group (18.1%).


CONCLUSIONS
When used according to our protocols, oral progesterone and IM progesterone result in comparable levels of circulating progesterone. However, oral progesterone results in a reduced implantation rate per embryo.
Licciardi
F L
FL
Department of Obstetrics and Gynecology, New York University School of Medicine, New York 10016, USA.
Kwiatkowski
A
A
Noyes
N L
NL
Berkeley
A S
AS
Krey
L L
LL
Grifo
J A
JA
D000284:Administration, Oral; D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007273:Injections, Intramuscular; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000008:administration & dosage* / Q000097:blood; D011446:Prospective Studies
D011374:Progesterone