G. Ragni et al., Endometrial morphology and ultrasound vascular findings - A randomized trial after intramuscular and vaginal progesterone supplementation in IVF, GYNECOL OBS, 47(3), 1999, pp. 151-156
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.