Comparison between two forms of vaginally administered progesterone for luteal phase support in assisted reproduction cycles

Abstract

The use of progesterone for luteal phase support has been demonstrated to be beneficial in assisted reproduction cycles using gonadotrophin-releasing hormone analogues (GnRHa). Two micronized progesterone preparations are available for vaginal administration: capsules and gel. The objective of this study was to compare the efficacy of these two forms for luteal phase support in assisted reproduction cycles. A total of 244 couples undergoing IVF/intracytoplasmic sperm injection cycles were included in the study and were randomly allocated (sealed envelopes) into two groups: group 1 (122) received vaginal capsules of 200 mg of micronized progesterone (Utrogestan), 3 times daily, and group 2 (122) received micronized progesterone in gel (Crinone 8%), once daily. Both groups received progesterone for 13 days beginning day 1 after oocyte retrieval, continuing until the pregnancy test was performed and until 12 weeks of pregnancy. Groups were compared by clinical data and assisted reproduction results and had similar ages and causes of infertility. Although the pregnancy rate was higher for those receiving progesterone gel than capsules (44.26 and 36.06% respectively), this difference was not statistically significant. The study showed that vaginal progesterone gel and capsules used for luteal phase support in assisted reproduction cycles with long protocol GnRHa result in similar pregnancy rates.

Freeze-all cycle for all normal responders?

“…On the third day following oocyte retrieval, embryo quality was evaluated and embryo transfer was performed (the fresh group) or the entire cohort was cryopreserved (the freeze-all group). Patients submitted to a fresh embryo transfer received vaginal micronized progesterone in gel formulation (Crinone® 8%; Merck Serono) for a single daily administration [25] starting on the day of oocyte retrieval. Progesterone was used for at least 13 days, when a pregnancy test was performed, and until 9 weeks if pregnancy was confirmed.…”

Progesterone vaginal capsule versus vaginal gel for luteal support in normoresponder women undergoing long agonist IVF/ICSI cycles

“…It suggested that initiating LPS treatment on either hCG day, oocyte retrieval day or embryo transfer day makes no difference as far as the ongoing pregnancy rates are concerned (respectively 20.8%, 22.7% and 23.6%) [7]. The general global approach to LPS in IVF treatments has been to use vaginal progesterone, particularly vaginal gel, due to its minimal side-effect spectrum and ease of application [24][25][26][27][28]. However, studies comparing different vaginal progesterone formulations with regard to IVF success did not go beyond a limited number [24][25][26][27][28][29][30].…”

“…The general global approach to LPS in IVF treatments has been to use vaginal progesterone, particularly vaginal gel, due to its minimal side-effect spectrum and ease of application [24][25][26][27][28]. However, studies comparing different vaginal progesterone formulations with regard to IVF success did not go beyond a limited number [24][25][26][27][28][29][30]. Detailed analysis of the available literature revealed a very limited number of studies investigating the differences of the vaginal forms, except for two recent large randomized trials [28,30].…”

Birth of a normal child after in vitro fertilization treatment followed by dengue fever

“…The reminders were vitrified as previously published [16]. Luteal phase support was performed with a single daily administration of vaginal micronized progesterone in gel (Crinone 8 %, Merck Serono, Brazil), starting on the evening of day 1 after oocyte retrieval [17].…”