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KMID : 1189220100370010041
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Korean Journal of Reproductive Medicine
2010 Volume.37 No. 1 p.41 ~ p.48
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Sequential use of intramuscular and oral progesterone for luteal phase support
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Kim Sang-Don
Kim Seok-Hyun
Moon Shin-Yong
Jee Byung-Chul
Lee Jung-Ryeol
Suh Chang-Suk
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Abstract
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Objectives: The aim of this study was to assess appropriate time to convert intramuscular progesterone support to oral administration for luteal phase support in in vitro fertilization (IVF).
Methods: Seventy-six cycles of IVF in which fetal heart beat was identified after treatment were included. Patients underwent controlled ovarian hyperstimulation with GnRH agonist long protocol (n=7) or GnRH antagonist protocol (n=66). Cryopreserved embryo transfer was performed in three cycles. Luteal support was initiated by daily intramuscular injection of progesterone, and after confirmation of fetal heart beat, converted to oral micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg daily before or after 8 gestational weeks. The oral progesterone was continued for 11 weeks.
Results: Overall clinical abortion rate was 3.9% (3/76) and mean time to conversion was 8+4 gestational weeks (46±5.8 days after oocytes retrieval). The abortion rate was 5.6% (1/17) and 3.4% (2/59) in patients with conversion before 7 weeks and after 8 weeks, respectively, which were not statistically significant (p=0.678). The miscarriages were occurred at 9+4 weeks, 11+3 weeks and 11+4 weeks.
Conclusion: Sequential luteal support using intramuscular and oral progesterone yields a relatively low clinical abortion rate. If fetal heart beat confirmed, sequential regimen appears to be safe and convenient method to reduce patients’ discomfort induced by multiple injections.
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KEYWORD
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Luteal phase support, Oral progesterone, In vitro fertilization
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