Luteal Phase Support in Intrauterine Insemination Cycles: A Randomized Clinical Trial of Vaginal Versus Intramuscular Progesterone Administration
- PMID: 36045877
- PMCID: PMC9361730
- DOI: 10.18502/jri.v23i1.8450
Luteal Phase Support in Intrauterine Insemination Cycles: A Randomized Clinical Trial of Vaginal Versus Intramuscular Progesterone Administration
Abstract
Background: Different progesterone doses and routes are used for luteal phase support in stimulated intrauterine insemination (IUI) cycles, but the optimal supplementation scheme has not yet been determined. Therefore, our aim was to compare the administration of two different doses of vaginal progesterone with two doses of intramuscular (IM) progesterone for luteal phase support in patients undergoing IUI cycles.
Methods: In this randomized clinical trial, 312 women with unexplained or malefactor infertility intending to start IUI cycles between April 2015 and January 2018 were included. They were randomized into four groups (n=78/each) including group 1 who received IM progesterone in oil (25 mg daily), group 2 who received IM progesterone in oil (50 mg daily), group 3 who received progesterone suppository (400 mg daily), and group 4 who received progesterone suppository (800 mg daily; 400 mg twice daily). The primary outcome was the clinical pregnancy rate. The ongoing pregnancy rate, abortion rate, and patients' satisfaction, and convenience the secondary outcomes.
Results: In our study, the overall clinical and ongoing pregnancy rates per cycle with COS and IUI were 16.02% and 12.8%, respectively. There were no significant differences in clinical pregnancy, ongoing pregnancy, and abortion rates among groups (p=0.84). The overall patients' satisfaction and convenience was significantly higher in the vaginal progesterone suppository groups than the IM progesterone groups (p=0.001).
Conclusion: The results of this study showed that vaginal progesterone administration provides a more easy-to-use and convenient method than IM progesterone administration for luteal phase support in IUI cycles with comparable pregnancy rates.
Keywords: Gonadotropins; Infertility; Injections; Intramuscular administration; Luteal phase; Male; Progestins.
Copyright© 2022, Avicenna Research Institute.
Conflict of interest statement
Conflict of Interest The authors declare no conflict of interest.
Similar articles
-
The effect of luteal-phase support with vaginal progesterone on pregnancy rates in gonadotropin and clomiphene citrate/intra-uterine insemination cycles in unexplained infertility: A prospective randomised study.J Obstet Gynaecol. 2016 Aug;36(6):794-799. doi: 10.3109/01443615.2016.1154511. Epub 2016 May 5. J Obstet Gynaecol. 2016. PMID: 27146108 Clinical Trial.
-
Luteal phase support with progesterone in intrauterine insemination: a prospective randomized study.Gynecol Endocrinol. 2014 Mar;30(3):197-201. doi: 10.3109/09513590.2013.859242. Epub 2014 Jan 7. Gynecol Endocrinol. 2014. PMID: 24397361 Clinical Trial.
-
Comparison of oral dydrogesterone with vaginal progesteronefor luteal support in IUI cycles: a randomized clinical trial.Iran J Reprod Med. 2015 Jul;13(7):433-8. Iran J Reprod Med. 2015. PMID: 26494991 Free PMC article.
-
Vaginal versus intramuscular progesterone for luteal phase support in assisted reproductive techniques: a systematic review and meta-analysis of randomized controlled trials.Gynecol Endocrinol. 2020 May;36(5):389-397. doi: 10.1080/09513590.2020.1727879. Epub 2020 Feb 14. Gynecol Endocrinol. 2020. PMID: 32054365
-
The role of luteal support during IVF: a qualitative systematic review.Gynecol Endocrinol. 2019 Oct;35(10):829-834. doi: 10.1080/09513590.2019.1603288. Epub 2019 Apr 29. Gynecol Endocrinol. 2019. PMID: 31032676
Cited by
-
Comparing the outcomes of in-vitro fertilization in patients receiving vaginal, subcutaneous, and intramuscular progesterone for luteal phase support: a three-armed randomized controlled trial.BMC Womens Health. 2024 Sep 2;24(1):481. doi: 10.1186/s12905-024-03337-z. BMC Womens Health. 2024. PMID: 39223536 Free PMC article. Clinical Trial.
References
-
- Cohlen BJ. Should luteal phase support be introduced in ovarian stimulation/IUI programmes? an evidence-based review. Reprod Biomed Online. 2009;19 Suppl 4:31–8. - PubMed
-
- Fauser BCJM, Devroey P. Reproductive biology and IVF: ovarian stimulation and luteal phase consequences. Trends Endocrinol Metab. 2003;14(5):236–42. - PubMed
-
- Erdem A, Erdem M, Atmaca S, Guler I. Impact of luteal phase support on pregnancy rates in intrauterine insemination cycles: a prospective randomized study. Fertil Steril. 2009;91(6):2508–13. - PubMed
LinkOut - more resources
Full Text Sources
Miscellaneous