Vaginal micronized progesterone versus intramuscular progesterone for luteal support in women undergoing in vitro fertilization-embryo transfer.
OBJECTIVE
To study the outcome of IVF-ET in women who used vaginal P (vaginal P(4)) versus those who used P in oil via IM injection (IM-P(4)) for luteal support.


METHODS
Retrospective cohort.


METHODS
Tertiary referral infertility center.


METHODS
A cohort of 544 women.


METHODS
In 145 women, vaginal P(4) was used, while in 399 women, IM-P(4) was used for luteal support.


METHODS
The primary outcome was ongoing pregnancy rate. Secondary outcomes included other IVF-ET outcomes: rates of clinical pregnancy and pregnancy loss (chemical and miscarriage) and serum P levels during the luteal phase and early pregnancy.


RESULTS
Women who used vaginal P(4) for luteal support had ongoing pregnancy rates (odds ratio [OR], 1.0675; 95% confidence interval [CI], 0.7587-1.5020) and rates of total pregnancy loss (OR, 1.0775; 95% CI, 0.7383-1.5727) that were not statistically different from those who used IM-P(4). During the luteal phase, women who used vaginal P(4) had mean serum P levels that were not statistically different from those who used IM-P(4). However, during early pregnancy, mean P levels in pregnant women who used vaginal P(4) were statistically significantly higher.


CONCLUSIONS
In women undergoing IVF-ET according to the GnRH agonist long protocol, luteal support with vaginal P(4) was associated with treatment outcomes that were no different from those associated with IM-P(4) luteal support.
Mitwally
Mohamed F
MF
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA. mmitwally@yahoo.com
Diamond
Michael P
MP
Abuzeid
Mostafa
M
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D015331:Cohort Studies; D003338:Corpus Luteum / Q000187:drug effects / Q000502:physiology*; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D054315:Oocyte Retrieval / Q000379:methods; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D012189:Retrospective Studies; D014621:Vagina / Q000378:metabolism; D055815:Young Adult
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone