Effects of intramuscular and vaginal progesterone supplementation on frozen-thawed embryo transfer

Lei Jiang,Zhuo-Ye Luo,Bu-Lang Gao,Gui-Min Hao

doi:10.1038/s41598-019-51717-5

Abstract

This study was to investigate effects of progesterone vaginal sustained-release gel and intramuscular injection of progesterone on frozen-thawed embryos transfer in 3013 patients receiving vaginal progesterone sustained-release gel and progesterone injection in artificial cycle for frozen-thawed embryo transfer. All patients were divided into two groups: group A with progesterone intramuscular injection (60 mg/d) plus dydrogesterone (10 mg tid) and group B with progesterone vaginal sustained-release gel of progesterone (90 mg/d) plus dydrogesterone (10 mg tid). There were 1988 women in group A treated with progesterone injection and 1025 women in group B with progesterone vaginal sustained-release gel. There were no statistically (P > 0.05) significant difference between the two groups in age, years of infertility, body mass index, endometrial thickness at transfer time, the average numbers of embryo transferred, cause of infertility, number of cycles, pregnancy rate and ectopic pregnancy rate. No significant (P > 0.05) differences existed in the clinical pregnancy (52.5% vs. 56.0%) and ectopic pregnancy (2.2% vs. 3.0%) rate between groups A and B. However, group B with vaginal progesterone supplementation had significantly (P < 0.05) greater implantation (37.0% vs 34.4%), delivery (45.1% vs. 41.0%) and live birth (45.0% vs. 40.8%) rate than group A with intramuscular progesterone injection, whereas group A had significantly (P < 0.05) greater early abortion rate (19.4% vs. 15.3%) than group B. This study showed that vaginal gel progesterone supplementation has good effects on frozen-thawed embryo transfer and can significantly increase the rate of implantation, delivery and live birth but decrease the abortion rate compared with intramuscular progesterone injection.

Highlights

This study was to investigate effects of progesterone vaginal sustained-release gel and intramuscular injection of progesterone on frozen-thawed embryos transfer in 3013 patients receiving vaginal progesterone sustained-release gel and progesterone injection in artificial cycle for frozen-thawed embryo transfer
No significant (P > 0.05) differences existed in the clinical pregnancy (52.5% vs. 56.0%) and ectopic pregnancy (2.2% vs. 3.0%) rate between groups A and B (Table 2)
We investigated the effects of two approaches for progesterone supplementation for luteal phase support in frozen-thawed embryo transfer (FET) and found that vaginal progesterone supplementation could significantly (P < 0.05) increase the implantation, delivery and live birth rate while decreasing early abortion rate compared with intramuscular progesterone injection in a cohort of Chinese women of around 30 years of age

Summary

Introduction

This study was to investigate effects of progesterone vaginal sustained-release gel and intramuscular injection of progesterone on frozen-thawed embryos transfer in 3013 patients receiving vaginal progesterone sustained-release gel and progesterone injection in artificial cycle for frozen-thawed embryo transfer. Group B with vaginal progesterone supplementation had significantly (P < 0.05) greater implantation (37.0% vs 34.4%), delivery (45.1% vs 41.0%) and live birth (45.0% vs 40.8%) rate than group A with intramuscular progesterone injection, whereas group A had significantly (P < 0.05) greater early abortion rate (19.4% vs 15.3%) than group B. This study showed that vaginal gel progesterone supplementation has good effects on frozen-thawed embryo transfer and can significantly increase the rate of implantation, delivery and live birth but decrease the abortion rate compared with intramuscular progesterone injection. There are three approaches for progesterone support in the luteal phase: intramuscular injection, oral and vaginal supplementation. Controversy exists with regard to the approach of progesterone supplementation and its clinical effects on clinical pregnancy, implantation, early abortion, delivery and live birth rates. Since the combination of two luteal support drugs can reduce side effects and absorption problems caused by large doses of one single drug and can reduce the rate of early vaginal bleeding after transplantation, dydrogesterone (10 mg tid, Dphaston, Abbott Healthcare, USA) was added in the study

Methods

Results

Conclusion