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

Mohamed F. Mitwally, Michael P. Diamond, Mostafa Abuzeid

Research output: Contribution to journalArticle

27 Scopus citations


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
Issue number2
StatePublished - Jan 15 2010
Externally publishedYes



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

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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