Intra muscular versus intra vaginal progesterone as luteal phase and early pregnancy support in patients undergoing IVF-ET

Abstract

Objective: Comparison of Intramuscular and Intravaginal progesterone as a luteal phase and early pregnancy support in patients undergoing IVF-ET. Design: Randomized, prospective study. Materials and Methods: A randomized prospective trial of luteal and early pregnancy supplementation by intra-muscular progesterone, group I (50 mg/day) or Intravaginal micronized progesterone, group II (600 mg/day) was conducted in 100 women selected for IVF-ET. Progesterone administration was initiated from the day of oocyte retrieval until the 12th week of pregnancy. Stimulation was done using GnRHa and FSH. Results: Higher clinical pregnancy rate was observed in group II (micronized preogesterone)-34% compare to group I (Intramuscular progesterone) 26%. The implantation rate in group I was less compared to patients in group II. Though there was lower plasma progesterone in group II, lower Ist trimester abortion rate was observed. Outcome of the two protocols: The two groups were comparable for age and indications of IVF-ET. Two embryo were transferred in each patient. There was higher total pregnancy rate in patients supplemented with Intravaginal progesterone. No local intolerance like pruritis and discharge was described by patients receiving intravaginal progesterone. Most women complained of pain from the I/M injections. Conclusion: Intravaginal micronised progesterone was well tolerated by all patients and appeared to be more effective than Intramuscular progesterone.