A meta-analysis of the route of administration of luteal phase support in assisted reproductive technology: vaginal versus intramuscular progesterone

Paul W Zarutskie, P.W. Zarutskie, James A. Phillips
Fertility and sterility · 2009 · vol. 92(1) , pp. 163–169 · doi:10.1016/j.fertnstert.2009.02.018 · PMID:19362303 · W2039002801
Systematic review / meta-analysis OA: closed CC0 ⤵ 3 in-corpus citations
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This meta-analysis compared vaginal versus intramuscular progesterone for luteal phase support in assisted reproductive technology, evaluating its impact on outcomes.

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Abstract

OBJECTIVE: To perform an analysis of data with consideration for the current clinically accepted vaginal progesterone (P) or intramuscular (IM) P dosing regimens and the clinically relevant randomized clinical trials published during the time frame 1992 to 2008. DESIGN: Meta-analysis of progesterone luteal support in IVF cycles using odds ratios (OR) and 95% confidence intervals (CI). SETTING: Previously conducted randomized clinical trials meeting acceptance criteria. PATIENT(S): Infertility patients. INTERVENTION(S): Progesterone (50 mg) IM daily or 200 mg P-in-oil capsules three times a day vaginally or 90 mg P in bioadhesive gel daily vaginally. MAIN OUTCOME MEASURE(S): Clinical pregnancy, ongoing pregnancy, miscarriage. RESULT(S): This analysis showed a comparable effect between vaginal progesterone as an oil-in-capsule or as a bioadhesive gel and IM P administration on the endpoints of clinical pregnancy (OR = 0.91, 95% [CI 0.74, 1.13]) and ongoing pregnancy (OR = 0.94, 95% [CI 0.71, 1.26]). A nominally significantly lower rate of miscarriage was observed with vaginal P compared with IM P (OR = 0.54, 95% [CI 0.29, 1.02]). CONCLUSION(S): Administration of vaginal P is comparable to administration of IM P for luteal phase support in assisted reproductive technology.

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MeSH descriptors

Corpus Luteum Fertilization in Vitro Progesterone Progesterone Reproductive Techniques, Assisted Administration, Intravaginal Administration, Oral Capsules Corpus Luteum Corpus Luteum Female Fertilization in Vitro Humans Injections, Intramuscular Odds Ratio Pregnancy Progesterone Randomized Controlled Trials as Topic Reproductive Techniques, Assisted

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