Comparison of Vaginal Gel and Intramuscular Progesterone for Fertilization and Embryo Transfer with Gonadotropin-Releasing Hormone Antagonist Protocol.

Chin Med J (Engl)

Center for Reproductive Medicine, Peking University Third Hospital; Department of Obstetrics and Gynecology, Peking University Third Hospital; Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China.

Published: July 2018

AI Article Synopsis

  • The study compares the effectiveness of vaginal progesterone (VP) versus intramuscular progesterone (IMP) for luteal support in young women (ages 18-35) undergoing IVF-ET with a GnRH-antagonist protocol.
  • A total of 1760 patients were analyzed, with the VP group showing a higher live birth rate (38.55%) compared to the IMP group (30.79%).
  • No significant differences were found in ectopic pregnancy or abortion rates between the two groups, indicating that VP may lead to better overall clinical outcomes for this population.

Article Abstract

Background: Luteal support is a key to patients undergoing in vitro fertilization and embryo transfer (IVF-ET) with gonadotropin-releasing hormone (GnRH)-antagonist protocol. This study aimed to compare the effect between vaginal progesterone (VP) and intramuscular progesterone (IMP) with GnRH-antagonist protocol after IVF-ET.

Methods: A total of 1760 patients (18 years ≤ age ≤35 years) undergoing IVF-ET with GnRH-antagonist protocol were studied retrospectively between September 2014 and August 2015 in Peking University Third Hospital. In the patients, 1341 patients received VP (VP group) and 419 patients received IMP (IMP group) as luteal support. We compared clinical outcomes between these two groups. The primary objective of the study was the live birth rate. Measurement data between the two groups were conducted using independent samples t-test. The variables in line with non-normal distribution were expressed as median (p25 and p75) and were compared using nonparametric Mann-Whitney U-test.

Results: Live birth rate in VP group was 38.55%, significantly higher than that in the IMP group, which was 30.79% (χ = 8.287, P = 0.004). The clinical intrauterine pregnancy rate and implantation rate in VP group were also significantly higher than those in the IMP group (clinical intrauterine pregnancy rate 47.35% vs. 41.29%, χ = 4.727, P = 0.030; implantation rate 30.99% vs. 25.26%, χ = 14.546, P < 0.001). Any statistically significant differences in ectopic pregnancy and abortion rates between two groups were not observed.

Conclusion: : Luteal support with VP had better clinical outcomes for young women undergoing IVF-ET with GnRH-antagonist protocol.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032680PMC
http://dx.doi.org/10.4103/0366-6999.235106DOI Listing

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