Endometrial morphology and ultrasound vascular findings - A randomized trial after intramuscular and vaginal progesterone supplementation in IVF

Luteal-phase supplementation has proved necessary in Gn-RH analog and human gonadotropin-stimulated cycles. We studied the effects of vaginally and in tramuscularly delivered progesterone on the endometrium. Thirty patients en rolled in an IVF program without embryo transfer due to absence of fertiliz ation were included in the study. Patients were randomly allocated to two t reatment groups. Group A(n = 15)was administered 200 mg progesterone b.i.d. by the vaginal route (Esolut, Angelini) starting on the day of oocyte pick up and group B (n = 15) was given 100 mg intramuscular progesterone once d aily (Prontogest, Amsa). Six days after HCG administration, biopsies were o btained for endometrial histological maturation and estrogen (ER) and proge sterone (PR) receptor analyses. In addition, ultrasound measurements of end ometrial thickness were made and uterine and myometrial artery flow was det ermined. Serum concentrations of estriol and progesterone were measured on the day of HCG, at oocyte pick up and at endometrial biopsy. The two treatm ent groups were similar in terms of follicular phase parameters during supe rovulation with Gn-RH analog and gonadotropin, Histologic, receptor and ult rasonographic analyses showed no significant differences between the two tr eatment groups. Our results indicate that both intramuscular and vaginal pr ogesterone are equally effective on the endometrium.