Vaginal micronized progesterone versus intramuscular progesterone for luteal support in women undergoing in vitro fertilization-embryo transfer

Mohamed F. Mitwally, Michael Peter Diamond, Mostafa Abuzeid

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: To study the outcome of IVF-ET in women who used vaginal P (vaginal P4) versus those who used P in oil via IM injection (IM-P4) for luteal support. Design: Retrospective cohort. Setting: Tertiary referral infertility center. Patient(s): A cohort of 544 women. Intervention(s): In 145 women, vaginal P4 was used, while in 399 women, IM-P4 was used for luteal support. Main Outcome Measure(s): 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. Result(s): Women who used vaginal P4 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-P4. During the luteal phase, women who used vaginal P4 had mean serum P levels that were not statistically different from those who used IM-P4. However, during early pregnancy, mean P levels in pregnant women who used vaginal P4 were statistically significantly higher. Conclusion(s): In women undergoing IVF-ET according to the GnRH agonist long protocol, luteal support with vaginal P4 was associated with treatment outcomes that were no different from those associated with IM-P4 luteal support.

Original languageEnglish (US)
Pages (from-to)554-569
Number of pages16
JournalFertility and sterility
Volume93
Issue number2
DOIs
StatePublished - Jan 15 2010

Fingerprint

Embryo Transfer
Corpus Luteum
Fertilization in Vitro
Progesterone
Pregnancy Rate
Luteal Phase
Pregnancy
Odds Ratio
Outcome Assessment (Health Care)
Confidence Intervals
Spontaneous Abortion
Serum
Tertiary Care Centers
Gonadotropin-Releasing Hormone
Infertility
Pregnant Women
Oils
Injections

Keywords

  • IM-P
  • in vitro fertilization
  • luteal support
  • micronized vaginal progesterone

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Vaginal micronized progesterone versus intramuscular progesterone for luteal support in women undergoing in vitro fertilization-embryo transfer. / Mitwally, Mohamed F.; Diamond, Michael Peter; Abuzeid, Mostafa.

In: Fertility and sterility, Vol. 93, No. 2, 15.01.2010, p. 554-569.

Research output: Contribution to journalArticle

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abstract = "Objective: To study the outcome of IVF-ET in women who used vaginal P (vaginal P4) versus those who used P in oil via IM injection (IM-P4) for luteal support. Design: Retrospective cohort. Setting: Tertiary referral infertility center. Patient(s): A cohort of 544 women. Intervention(s): In 145 women, vaginal P4 was used, while in 399 women, IM-P4 was used for luteal support. Main Outcome Measure(s): 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. Result(s): Women who used vaginal P4 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-P4. During the luteal phase, women who used vaginal P4 had mean serum P levels that were not statistically different from those who used IM-P4. However, during early pregnancy, mean P levels in pregnant women who used vaginal P4 were statistically significantly higher. Conclusion(s): In women undergoing IVF-ET according to the GnRH agonist long protocol, luteal support with vaginal P4 was associated with treatment outcomes that were no different from those associated with IM-P4 luteal support.",
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