Crinone 8% vaginal progesterone gel results in lower embryonic implantation efficiency after in vitro fertilization-embryo transfer.
OBJECTIVE
To evaluate the outcome of IVF-ET after the use of Crinone 8% (Wyeth-Ayerst Laboratories, Inc., Philadelphia, PA) vaginal progesterone gel and to compare these results with those seen in our program with the use of IM progesterone-in-oil.


METHODS
Retrospective cohort study.


METHODS
A tertiary referral reproductive medicine unit.


METHODS
Patients <40 years of age undergoing IVF-ET cycles.


METHODS
Patients were treated with either Crinone 8% vaginal progesterone gel (90 mg) administered daily or IM progesterone-in-oil (50 mg) administered daily.


METHODS
Biochemical pregnancy rate, implantation rate, and clinical and ongoing pregnancy rates.


RESULTS
The use of Crinone 8% vaginal progesterone gel was associated with a lower implantation rate (16.6% versus 26.2%; odds ratio [OR] = 0.56; 95% confidence interval [CI], 0.35-0.89) compared with the use of IM progesterone-in-oil. Biochemical pregnancies were more common after the use of Crinone 8% vaginal progesterone gel as defined by either biochemical pregnancies per transfer (15.9% versus 5.7%; OR = 3.11; 95% CI, 1.17-8.32) or biochemical pregnancies as a proportion of positive serum hCG titers (29.2% versus 9.8%; OR = 3.80; 95% CI, 1.33-10.86). Clinical pregnancy rates also were lower with the use of Crinone 8% vaginal progesterone gel (36.4% versus 52.9%; OR = 0.51; 95% CI, 0.26-0.99).


CONCLUSIONS
Implantation efficiency is reduced, as demonstrated by lower embryonic implantation rates and higher biochemical pregnancy rates, when Crinone 8% vaginal progesterone gel rather than IM progesterone-in-oil is used for luteal phase support after IVF-ET.
Damario
M A
MA
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Goudas
V T
VT
Session
D R
DR
Hammitt
D G
DG
Dumesic
D A
DA
D000282:Administration, Intravaginal; D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005782:Gels; D006801:Humans; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D012189:Retrospective Studies
C400424:Crinone; D005782:Gels; D011374:Progesterone