Intramuscular progesterone versus 8% Crinone vaginal gel for luteal phase support for day 3 cryopreserved embryo transfer

Capsule:
Luteal support with 8% Crinone was associated with lower odds of clinical pregnancy and live birth compared with intramuscular progesterone in a multivariable analysis of day 3 cryopreserved embryo transfer cycles.

Authors:
Daniel J. Kaser, M.D., Elizabeth S. Ginsburg, M.D., Stacey A. Missmer, Sc.D., Katharine F. Correia, M.A., Catherine Racowsky, Ph.D.

Volume 98, Issue 6, Pages 1464-1469, December 2012

Abstract:

Objective:
To compare outcomes following intramuscular 84 progesterone (IMP) or 8% Crinone vaginal gel for luteal support for day 3 cryopreserved embryo transfer (CET).

Design:
Retrospective cohort study with multivariable analysis.

Setting:
Academic medical center.

Patients:
All autologous and donor egg IVF and ICSI patients who had a day 3 CET between January 1, 2008 and April 30, 2011 with luteal support using IMP 25-50 mg/d or Crinone 8% twice daily, initiated 3 days before the CET.

Interventions:
None.

Main outcome measures:
Implantation rate, clinical pregnancy and live birth rates per CET.

Results:
IMP (n=440) and Crinone (n=298) recipients were similar for all demographic characteristics and cycle parameters assessed. While implantation rates did not differ significantly for the two progesterone groups (Crinone vs. IMP: 19.6% vs. 30.4%), women supplemented with Crinone had significantly lower rates of clinical pregnancy (36.9% vs. 51.1%) and live birth (24.4% vs. 39.1%) compared with those on IMP.

Conclusions:
We observed that Day 3 CET cycles with Crinone 8% luteal support have a 44% and 49% lower odds of clinical pregnancy and live birth, respectively, compared to those with IMP support. Further studies are required to identify the optimal timing and dose of Crinone 8% vaginal gel for use in CET cycles.

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