Crinone 8%* vaginal progesterone gel results in lower embryonic implantation efficiency after in vitro fertilization-embryo transfer

Objective: To evaluate the outcome of NF-ET after the use of Crinone 8% (Wy eth-Ayerst Laboratories, Inc., Philadelphia, PA) vaginal progesterone gel a nd to compare these results with those seen in our program with the use of IM progesterone-in-oil. Design: Retrospective cohort study. Setting: A tertiary referral reproductive medicine unit. Patient(s): Patients <40 years of age undergoing IVF-ET cycles. Intervention(s): Patients were treated with either Crinone 8% vaginal proge sterone gel (90 mg) administered daily or LM progesterone-in-oil (50 mg) ad ministered daily. Main Outcome Measure(s): Biochemical pregnancy rate, implantation rate, and clinical and ongoing pregnancy rates. Result(s): The use of Crinone 8% vaginal progesterone gel was associated wi th a lower implantation rate (16.6% versus 26.2%; odds ratio [OR] = 0.56; 9 5% confidence interval [CI], 0.35-0.89) compared with the use of IM progest erone-in-oil. Biochemical pregnancies were more common after the use of Cri none 8% vaginal progesterone gel as defined by either biochemical pregnanci es per transfer (15.9% versus 5.7%; OR = 3.11; 95% CI, 1.17-8.32) or bioche mical pregnancies as a proportion of positive serum hCG titers (29.2% versu s 9.8%; OR = 3.80; 95% CI, 1.33-10.86). Clinical pregnancy rates also were lower with the use of Crinone 8% vaginal progesterone gel (36.4% versus 52. 9%; OR = 0.51; 95% CI, 0.26-0.99). Conclusion(s): Implantation efficiency is reduced, as demonstrated by lower embryonic implantation rates and higher biochemical pregnancy rates, when Crinone 8% vaginal progesterone gel rather than IM progesterone-in-oil is u sed for luteal phase support after IVF-ET. (Fertil Steril(R) 1999;72:830-36 . (C) 1999 by American Society for Reproductive Medicine.).