Administration of Vaginal Progesterone Effect on Implantation Rates in Embryo Recipient
Relationship Between Sperm Survival Assay Results Performed forQC of Plastic Cultureware and IVF
Paternal Factors Predict Increased Rates of Aneuploidy in Egg Donor Cycles
Use of GnRH Antagonists in Egg Donation Cycles
Aneuploidy Rates In Young Egg Donors Related To Presence of Male Factor
NoEffect of IVF on Singleton Birth Weight and Pre-term Delivery Rate in Oocyte Donation Cycles
Sperm DNA Damage as Measured by SCSA Does Not Predict Sperm Survival Rate
Response to COH Does not Correlate with Singleton Birth Weight in Oocyte Donation Cycles
High Sperm DNA Fragmentation are Predictive of Poor Outcome in Egg Donation
Effect of Medications on Semen Analysis and SCSA
Cryopreservation No Effect on Implantation and Pregnancy Rates in Egg Donation
Surrogacy Enhances Implanatation Rates in Egg Donation
ICSI of Testicular Sperm Results in Higher Fertilization Rates than Ejaculated Sperm
Activation of Human Oocytes using Calcium Ionophore After ICSI Increases Fertilization
Insemination of Oocytes by IVF or ICSI does not Reduce Fertilization Rates
Surrogacy Enhances Pregnancy and Implantation Rates in Fresh and Frozen Embryo Transfers
Objective: Increasing evidence suggests that micronized intravaginal progesterone (IV-P) is as
effective as intramuscular (IM-P) in providing luteal support in embryo recipient cycles; however, the
optimal dosage of IV-P has not been established. The aim of this study was to examine the effect of
an increased dose of IV-P early in the luteal phase.
Design: Retrospective data analysis from embryo recipient cycles over a two-year period in a private
clinic.
Materials and Methods: Down-regulated patients were treated with biweekly IM estradiol valerate
and P was initiated on cycle day 12 in frozen embryo transfer cycles or on the day of egg retrieval in
egg donation cycles. Patients received one of three P regimens: 200 mg IV-P BID (n=95), 400 mg IVP
BID (n=46) or 50 mg/day IM-P in oil (n=29). On the day of ET, the P dose in each regimen was
doubled. Serum P levels were measured on the day of ET and 1 week later. Cycle outcomes were
compared for each of the 3 regimens.
Results: Mean recipient age (34.7 7y) and number of embryos transferred (2.7 0.9) were comparable
for the 3 regimens. Serum P levels with 200 mg IV-P were significantly lower compared to IM-P,
both on the day of ET and one week later (17.8 vs. 22 and 30.5 vs. 43.6 ng/ml respectively, p<0.05),
as were serum P levels with 400 mg IV-P compared to IM-P one week after ET (29.8 vs. 43.6 ng/ml;
p<0.05). There was no significant difference between serum P levels with 200 and 400 mg IV-P.
Pregnancy and implantation rates were significantly lower in recipients using 400 mg compared to 200
mg capsules when transfers were performed on day 2 or 3 of P support (54% and 25% for 400 mg, vs.
75% and 42% for 200 mg respectively; p<0.05) but not when extended culture was used. Within the
400 mg IV-P group, pregnancy (54% vs. 75%, p<0.05) and implantation rates (25% vs.47%, p<0.05)
were significantly higher when the increase in P dose occurred on day 4-5 rather than day 2-3 of luteal
support. There were no significant differences in outcomes between the 200 mg IV-P and IM-P
regimens or in miscarriage rates among the 3 regimens.
Conclusions: Increased doses of IV-P initiated during early (days 2 or 3), but not late (days 4 or 5), P
luteal support are associated with reduced pregnancy and implantation rates in recipient cycles. This
study suggests that high doses of vaginal P administered early in the luteal phase may have a
detrimental effect on implantation, possibly due to accelerated endometrial maturation resulting in an
alteration of the window of implantation.