Vaginal micronized progesterone versus intramuscular progesterone for luteal support in women undergoing in vitro fertilization-embryo transfer²

METHODS

Trial type: retrospective cohort study

Participants: 544 women undergoing IVF at a tertiary referral infertility centre

Primary outcome: ongoing pregnancy rate

Secondary outcomes: rates of clinical pregnancy and pregnancy loss (chemical and miscarriage), serum progesterone levels during the luteal phase and early pregnancy

Comparator agents: Endometrin^® (100 mg vaginal progesterone tablets; marketed as Lutigest^® in the UK) (n = 145) and 100mg intramuscular progesterone injections (n = 399)

Protocol: long GnRH agonist

RESULTS

Ongoing pregnancy rate: Lutigest^® not statistically different to IM progesterone [odds ratio (95% confidence interval): 1.0675 (0.7587-1.5020)]

Rates of total pregnancy loss: Lutigest^® not statistically different to IM progesterone [odds ratio (95% confidence interval): 1.0775 (0.7383-1.5727)]

Mean serum progesterone levels during luteal phase: Lutigest^® not statistically different to IM progesterone [0.8 +/- 0.4 (0.2-2.6) and 1.0 +/- 0.25 (0.4-1.0)]

Mean serum progesterone levels during early pregnancy: During early pregnancy, serum progesterone levels were statistically significantly higher in the Lutigest^® group on mean days (after oocyte retrieval) of 19-22, 23-26, and 27 days to 12 weeks of gestation.

Mean serum progesterone levels following oocyte retrieval (pregnant patients)

CONCLUSION

Luteal support with Lutigest^® was associated with treatment outcomes that were no different from those associated with IM progesterone.

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