Matched-samples comparison of intramuscular versus vaginal progesterone for luteal phase support after in vitro fertilization and embryo transfer

Objective: To evaluate vaginal compared to intramuscular (IM) progesterone supplementation for luteal phase support after in vitro fertilization and embryo transfer (IVF-ET). Design: Retrospective matched-samples comparative study. Setting: Private infertility center. Patients(s): Two hundred forty patients undergoing IVF-ET. Intervention(s): Patients received either vaginal progesterone supplementation in the form of Endometrin 100 mg twice a day (n = 12), Endometrin 100 mg three times a day (n = 11), or Crinone 8% get 90 mg every day (n = 17), or 50 mg every day IM progesterone in oil (n = 200). Main Outcome Measure(s): Clinical intrauterine pregnancy rates, pregnancy loss, and live birth rates. Result(s): Among patients using vaginal progesterone, there were no statistically significant differences in patient characteristics and clinical outcomes, regardless of the type of vaginal progesterone used. There were no differences in outcomes between the vaginal and IM progesterone treatment groups. There were 20 pregnancies (50.0%) among patients treated with vaginal progesterone and 103 pregnancies (51.5%) among matched IM progesterone patients. The live birth rates were 47% in the IM versus 47.5% in the vaginal progesterone groups. There were no statistically significant differences in miscarriage rates between groups. Conclusion(s): There are no significant differences in treatment outcomes between vaginal and IM progesterone supplementation, yielding similar clinical pregnancy, miscarriage, and live birth rates. (Fertil Steril (R) 2009;91: 2445-50. (C) 2009 by American Society for Reproductive Medicine.)