Your San Diego fertility center: Reproductive Sciences Center & Genetics Institute

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Early administration of additional vaginal progesterone support has a detrimental effect on implantation rates in embryo recipient cycles.

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.

 

 

Our fertility specialists at The Reproductive Sciences Center, or RSC, are conveniently located in La Jolla California in San Diego County. We have worked hard to create and maintain our reputation as the first-rate San Diego fertility clinic and sciences center. RSC has become synonymous with comprehensive and successful female and male infertility treatment, egg donor programs and surrogacy options, in vitro fertilization, ICSI and more.

While we have provided services to hundreds of patients throughout the Temecula, Murrieta, La Jolla, Riverside,San Bernardino and Encinitas areas, we also help many people from across the United States, Europe, Australia , Asia, Africa and the Americas who make us their final destination for treatment with infertility in San Diego. We lead the area as one of the leading fertility centers in the world.

Our fertility center has long been established as having one of the highest fertility success rates in the world, and with more than 75 years of combined medical training, experience and ongoing continuing education, our fertility specialists set the bar for the industry. Our medical director and leading fertility doctor is one of the most well-respected experts in the world.

Successful fertility treatment in San Diego is only possible with the best fertility specialists and staff in OrangeCounty. We have been providing unsurpassed treatment for infertility in San Diego, including IVF (In Vitro Fertilization) and other San Diego fertility services in La Jolla for more than a decade.

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