Comparing intramuscular progesterone, vaginal progesterone and 17 -hydroxyprogestrone caproate in IVF and ICSI cycle

Background: Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. Objective: The objective of this study was to compare the efficacy of three types of progesterone on biochemical, clinical and ongoing pregnancy rates and abortion and live birth rates. Materials and Methods: A prospective randomized study was performed at Royan Institute between March 2008 and March 2009 in women under 40 years old, who use GnRH analog down-regulation. One hundred eighty six patients in three groups were received progesterone in oil (100 mg, IM daily), intravaginal progesterone (400 mg, twice daily) and 17-α hydroxyprogestrone caproate (375mg, every three days), respectively. Results: Final statistical analysis after withdrawal of some patients was performed in 50, 50 and 53 patients in group 1, 2 and 3 respectively. No differences between the groups were found in baseline characteristics. No statistical significance different was discovered for biochemical, clinical and ongoing pregnancies. Although the abortion rate was statistically higher in group 1 (p=0.025) the live birth rate was not statistically significant between the three groups. Conclusion: The effects of three types of progesterone were similar on pregnancies rate. We suggest the use of intravaginal progesterone during the luteal phase in patients undergoing an IVF-ET program because of the low numbers of abortions, and high ongoing pregnancy rates.