Comparison of progesterone administration before and after embryo transfer in ART cycles

Aflatoonian, Abbas; Asgharnia, Maryam; Seyed Alshohadaei, Fariba

Comparison of progesterone administration before and after embryo transfer in ART cycles

Vol. 5, Issue 1, / January-March 2004
(pages 44-51)

Abbas Aflatoonian: - Department of Obstet . and Gynecol Research and Clinical Center for Infertility, Faculty of Medicine, Yazd Shahid Sadooghi University of Medical Sciences, Yazd, Iran
Maryam Asgharnia: - Department of Obstet . and Gynecol Faculty of Medicine, Gilan University of Medical sciences, Gilan, Iran
Fariba Seyed Alshohadaei: - Department of Obstet . and Gynecol Kordestan University of Medical Sciences, Kordestan, Iran

Received: 1/1/2004 Accepted: 1/1/2004 - Publisher : Avicenna Research Institute

Other Format

Abstract

Introduction: Nowadays the wide spread use of GnRH agonists in ART protocols has emerged the need for luteal phase support by progesterone. However the time of starting progesterone administration is still obscure, some investigators recommend the day of oocyte retrieval and the others later. The present study was designed to investigate the effect of the progesterone administration timing before or after embryo transfer on the outcome of ART. Materials and Methods: A randomized clinical trial was designed to study a total of 575 women referred to Shahid Sadooghi University of Medical Sciences and Yazd Madar Hospital, undergone ART treatment. Using long GnRH-a protocol, the patients were randomly divided into two groups. Progesterone administration was started on oocyte retrieval day in the first group (n= 307), versus after embryo transfer in the second group (n=268). Pregnancy rate were analyzed using statistical trials including 2 and T. Results: Regarding the age of couples, the duration and etiology of infertility, the number of follicles, retrieved oocytes and zygotes (3.01.4 in first group versus 2.81.4 in second group) no statistically significant difference was observed. The outcome, defined as a positive pregnancy test was not different in two groups. Conclusion: Considering the results and the disturbances following intramuscular injection of progesterone including the risk of bleeding, the administration of progesterone after embryo transfer is recommended.

Keywords: Infertility, Assisted Reproductive Techniques, Oocyte retrieval, Embryo transfer, Luteal phase support, Progesterone

To cite this article:

Aflatoonian A, Asgharnia M, Seyed Alshohadaei F. Comparison of progesterone administration before and after embryo transfer in ART cycles. J Reprod Infertil. 2004;5(1):44-51.

References

Smitz J., De vroey P., Camus M., et al. The luteal phase and early pregnancy after combined GnRH – agonist/ UMG treatment for superovul-ation in IVF or GIFT. Hum Reprod.1988;3:585-590.
Smith E.M., Anthony F.W., Gadd S.C., et al. Ttial of support treatment with human chorionic gonadotropin in the luteal phase after treatment with buserelin and human menopausal gonadotro-pin in women taking part in an in vitro fertiliza-tion programe. Br Med J. 1989;298:1483-1486.
Belaisch- Allat J., De Mouzon J., lapousterle C., et al. The effect of HCG supplementation after combined GnRH agonist/HMG treatment in IVF programe. Hum Reprod. 1990;5:163-166.
De Mouzony J., Hopital De Bicetre., le kremlin Bicetre, France. progestrone support during the net/ferimagazine/congress/2oo2-Eshre-03.asp.
Nikunen V., Katuinen P., Piroiuen D. Progestrone support of the luteal phase IVF program a hazard? Annual Gynecol.1988;202 (s):42-4.
Patrizio P., Tucker M.J., Guelman V. A color Atlas for human Assisted Reproduction, Williamz & Williams, 2003;pp:220-221.
Smitz J., Devroey P., Faguer B., et al. A prospective randomized comparison of intra-muscular or intravaginal natural progestrone as a luteal phase and early pregnancy supplement. Hum Reprod. 1992;7:168-175.
Araujo E J.R., Benar Dini L., Frederick J.L., et al. Prospective randomized comparison of human chorionic gonadotropin versus intra-muscular progestrone for luteal phase support in assisted reproduction. J Assist Reprod Genet. 1992;11:74-78.
Tavaniotou A., smitz J., Bougain C., Deroey P. Comparison between different routes of progestrone administration as luteal phase support infertility treatments. Hum Reprod. Update. 2000;6:139-148.
Deziegler D., Bulletti C. Progestrone: A natural, life supporting hormome. Hum Reprod. 2000;15.
Pritts E.A., Atwood A.K. Luteal phas support in infertility treatment: a meta- analysis of the randomized trial. Hum Reprod. 2002;17(9):228-9.
Bourgain C., smitz J., Camus M., Erard P., De vroey P., van steirteghen A.C., Kloppel G. Human endometrial maturation is markedly improved after luteal supplementation of gonadotropin releasing hormone analoge/ human menopausal gonadotropin stimulated cycles. Hum Reprod.1994;9:32-40.
Ludwig M., Diedrich K. Evaluation of an optimal luteal phase support protocol in IVF. Acta Obstet Gynecol Scand.2001;80:452-466.
Artini P.G., volpe A., Angioni S., Glassi M.C., Battaglia C., Genazzani A.R. A comparative , randomized study of the three different progestrone suport of the luteal phase following IVF/ ET program. J Endocrinol Invest.1995;18:51-56.
Soliman S., Daya S., Collins J., et al. The role of luteal phase support in infertility treat-ment: a meta-analysis of randomized trials. Fertil Steril.1994;61: 1068-1076.
Ragni G., piloni S., Rossi P., et al. Endo-metrial morphology and ultrasound vascular findings. A randomized trial after intramuscular and vaginal progestrone supplementation in IVF. Gynecol Obstet Invest. 1999;47:151-6.
Deveker F., Govaerts I., Bertrand E., Vanden Bergh M., Gerry C., Englert Y. The long-acting gonadotropin- releaing hormone analogues Impaired the implantation rate. Fertil Steril.1996; 65(10):122-6.
Kimzey L.M., Gumowsh J., Merriam G.R., Grimes G.J. Jr., Nelson L.M. Absorption of micronized progestrone from a nonliquifying.
Claman P., Domingo M., leader A. Luteal phase support in in-vitro fertilization using gonadotropin releasing hormone analogue before ovarian stimulation a prospective randomized study of human chorionic gonadotropin versus im progestrone. Hum Reprod. 1992;7:487-489.
Pouly J.L., Bassil S., Frydman R., et al. Support de laphose luteal par la progestron vaginale: etude comparative avec la progestrone micronisee per os. Contracept Fertil Sex.1997; 25:596-601.
Lenton E.A., Sulaiman R., Sobowale O., et al. The human menstrual cycle: Plasma concentra-tion of prolactin. LH,FSH, Oestradiol and progestrone in conceiving and nonconceivung women. J Reprod Fertil.1982;65:131-139.
Garcia J.E., Acosta A.A., Hsiu J.,G., et al. Advanced endometrial maturation after ovulation induction with human menopausal gonadotropin/ human chorionic gonadotropin for in vitro fertilization. Fertil Steril.1984;41: 31-35.
Yovich J.L., Mcclom S.C., Yovich J.M., et al. Early luteal serum progestrone concentrations are higher in pregnancy cycles. Fertil Steril.1985;44: 185-189.
Mochtar M.H., Hogerzeil H.V. Mel B.M. Progestrone alone versus progestrone combined with HCG as luteal support in GnRH-a/ HMG induced IVF cycles:a randomized clinical trial. Hum Reprod.1996;11:1602-1605.
Williams S.C., Ochninger S., Gibbons W.E., Van cleave W.C., Muasher S.J., Delaying the initiation of progestrone supplementation results in decerased pregnancy rates after in vitro fertilization: A randomized, prospective study. Fertil Steril.2001;76(6):1140-3.
Sohn S.H., Penzias A.S., et al. Progestrone administration befor oocyte retrieval decreased IVF succes. Fertil Steril.1999;71:11-4.
Chang S.Y., Soong Y.K., Chang M.Y., Hsiu O.Y., Immediate versus delayed progestrone Supplementation in gamete intrafallopian transfer (GIFT). J In vitro Fertil Embryo Transfer. 1989;6(5):275.