title: Greater implantation and pregnancy rates with vaginal progesterone in intracytoplasmic sperm injection but not in in vitro fertilization cycles: a retrospective study.
abstract: OBJECTIVE
  To compare the effectiveness of vaginal progesterone supplementation with intramuscular supplementation in assisted reproduction cycles.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Physiopathology of Human Reproduction Unit, Pordenone, Italy, from July 2000 to June 2004.
  
  
  METHODS
  Three hundred and eight-five intracytoplasmic sperm injection (ICSI) procedures (188 with vaginal gel and 197 with intramuscular progesterone) and 373 in vitro fertilization (IVF) cycles (227 with vaginal and 146 with intramuscular progesterone).
  
  
  METHODS
  Progesterone luteal supplementation: vaginal gel (Crinone 8% 90 mg/day) or intramuscular (Prontogest 50 mg/day).
  
  
  METHODS
  Implantation rates, and total and clinical pregnancy rates.
  
  
  RESULTS
  Higher rates of implantation and total and clinical pregnancies were observed in the vaginal supplemented ICSI subgroup than in the intramuscular one. This difference was observed for all transfers (13.3% vs. 8.8%, 39.8% vs. 23.3%, and 28.7% vs. 18.6%) and for ultrasound-guided transfers (17.2% vs. 9.3%, 49% vs. 27%, and 36.9% vs. 21.1%, respectively).
  
  
  CONCLUSIONS
  The vaginal route of luteal supplementation may be better than the intramuscular one, yielding higher implantation rates as well as total and clinical pregnancy rates in ICSI cycles but not in classic IVF treatments.
authors.affiliation: Service of Physiopathology of Human Reproduction, Maternal-Paediatric Department, Pordenone Hospital, Pordenone, Italy. serpma@aopn.fvg.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Manno
authors.forename: Emanuela
authors.initials: E
authors.lastname: Marchesan
authors.forename: Daniele
authors.initials: D
authors.lastname: Cicutto
authors.forename: Donatella
authors.initials: D
authors.lastname: Zadro
authors.forename: Cristina
authors.initials: C
authors.lastname: Favretti
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomei
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D016001:Confidence Intervals; D010064:Embryo Implantation / Q000187:drug effects* / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects* / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage*; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D011374:Progesterone