THERAPEUTICAL NOTES   

Minerva Ginecologica 2001 August;53(4):297-302

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Luteal phase support in assisted reproductive cycles using either vaginal (Crinone 8) or systemic (Prontogest) progesterone: results of a prospective, randomized study

Anserini P., Costa M., Remorgida V., Sarli R., Guglielminetti E., Ragni N.

Background. To compare local tolerance and patients' compliance to intravaginal and intramuscular progesterone administration.
Methods. Ninety-nine patients have been randomised to receive either intravaginal Crinone, 90 mg/day (n=51) or intramuscular Prontogest 50 mg/day (n=48) for luteal supplementation in IVF/ICSI cycles. Local and systemic side effects as well as pattern of menstrual bleeding were reported on a self administered questionnaire. Progesterone levels were evaluated pre-treatment, in the mid-luteal phase and the day of pregnancy test.
Results. Patients' age, BMI, duration and causes of infertility were comparable in the two treatment groups. All parameters of ovarian response as well as pregnancy rates did not show significative difference in the two groups. A significative larger number of patients assigned to intravaginal support were free from side effects. Furthermore side effects, when reported, resulted significantly more severe in the intramuscular group. In the non pregnant patients menstrual flow appeared significantly earlier in those treated with vaginal progesterone (p<0.001).
Conclusions. Crinone 8 is a good alternative to parental progesterone for luteal support in ART cycles. It is well tolerated but it is linked to an earlier appearance of menstrual flow in non conceptional cycles.