Photo Credit: Rattankun Thongbun
The following is a summary of “Comparison of the efficacy of vaginal micronised progesterone tablet and gel for in vitro fertilisation,” published in the December 2024 issue of Obstetrics and Gynecology by Han et al.
Luteal phase support (LPS) with progesterone is standard after controlled ovarian stimulation (COS), though optimal protocols are debated.
Researchers conducted a retrospective study to compare the efficacy of vaginal micronized progesterone tablets and 8% vaginal progesterone gel in LPS.
They reviewed 459 in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles (2005–2019), comparing 65 cycles using progesterone tablets and 394 cycles using progesterone gel. Doubly robust inverse-probability-of-treatment weighting (IPTW) based on covariate balancing propensity score (CBPS) and regression adjustment (RA) was used for analysis.
The results showed that women using progesterone tablets were more likely to be older (36 vs. 34 years), have primary infertility (78.5% vs. 61.4%), use gonadotropin-releasing hormone antagonists (60.0% vs. 43.2%), and have fewer retrieved oocytes (7 vs. 9) and transferred embryos (ET) (2 vs. 3) compared to those using progesterone gel. After adjustment for these factors, the adjusted odds for clinical pregnancy in the progesterone tablet group were 1.10 times higher than the gel group. However, the 95% CI (0.96–1.26) did not reach statistical significance.
They concluded that clinical pregnancy rates were similar between vaginal micronized progesterone tablets and progesterone gel for LPS in fresh day 3 ET cycles.
Source: tandfonline.com/doi/full/10.1080/01443615.2024.2436518
