- Nayereh Khadem
 - - Department of Obs. & Gyn, Faculty of Medicine, Mashad University of Medical Sciences, Mashad, Iran
- Masoumeh Anbar Looii
- - Department of Obs. & Gyn, Faculty of Medicine, Mashad University of Medical Sciences, Mashad, Iran
Received: 10/1/2007 Accepted: 10/1/2007 - Publisher : Avicenna Research Institute |
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Abstract
Introduction: Luteal phase support is practiced routinely in some medical centers in patients undergoing ovulation induction (OI) and intrauterine insemination (IUI) cycles. The purpose of this study was to compare the effects of progesterone in oil with 17-α-hydroxy progesterone caproate (17- HPC) for luteal phase support. Materials and Methods: This prospective randomized clinical trial was done at Montaserieh Infertility Center in Mashad, Iran, from October 2005 to October 2006. In this study, 162 patients undergoing OI and IUI were randomly treated with either 17-HPC (250 mg/weekly, IM) or progesterone in oil (50mg/daily, IM) until serum β-hCG was evaluated. In patients with positive β-hCG results (Biochemical pregnancy), the treatment was continued until the 12th week of gestation. The data were analyzed using t-tests, Chi-squared and Fishers exact test. P-values<0.05 were considered as the level of significance. results: the outcomes of iui in both study groups were compared. no differences were found in the outcome of pregnancies, considering parameters such as biochemical pregnancy (p="0.69)," clinical pregnancy (p="0.3)" or ongoing pregnancy up to the 20th week (p="0.831)." complications were significantly lower in 17-hpc group (p="0.002)" and the patients satisfaction was signi-ficantly higher compared to the other group (p="0.003)." conclusion: the results of this study confirm that 17-hpc has the same effects as oily progesterone for luteal phase support in patients undergoing oi and iui cycles and it could be used instead of progesterone in oil, although more studies are needed to support this replacement.< pan>
Keywords:
17-a-hydroxy progesterone caproate, Progesterone in oil, Natural progesterone, Intrauterin insemination, Intra uterine insemination, Luteal phase, Support To cite this article:References
- Simunic V, Tomic V, Tomic J, Nizic D. Comparative study of the efficacy and tolerability of two vaginal progesterone formulations, Crinone 8% gel and Utro-gestan capsules, used for luteal support. Fertil Steril. 2007;87(1):83-7.
- Yanushpolsky E, Hurwitz S, Greenberg L, Racowsky C, Hornstein M. Comparison of Crinone 8% intrava-ginal gel and intramuscular progesterone supplementa-tion for in vitro fertilization/ embryo transfer (IVF/ET) in women under age 40: A prospective randomized trial. Fertil Steril. 2006;86(3)suppl 1:S6.
- Costabile L, Gerli S, Manna C, Rossetti D, Di Renzo GC, Unfer V. A Prospective randomized study comparing intramuscular progesterone and 17alpha-hydroxy Progesterone Caproate in Patients undergoing in vitro fertilization-embryo transfer cycles. Fertil Steril. 2001;76(2):394-6.
- Licciardi FL, Kwiatkowski A, Noyes NL, Berkeley AS, Krey LL, Grifo JA. Oral versus intramuscular pro-gesterone for in vitro fertilization: a prospective rando-mized study. Fertil Steril. 1999;71(4):614-8.
- Miles RA, Paulson Rj, Lobo RA. Pharmacokinetics and endometrial tissue levels of progesterone after admi-nistration by intramuscular and vaginal routes; a com-parative study. Fertil Steril. 1994;62(3):485-90.
- Schmidt KLT, Ziebe S, Popovic B. Progesterone supplementation during early gestation after in vitro fertilization has no effect on the delivery rate. Fertil Steril. 2001;75(2):337-41.
- Damario MA, Goudas VT, Session DR, Hammitt DG, Dumesic DA. Crinone 8% vaginal progesterone gel results in lower embryonic implantation efficiency after in vitro fertilization-embryo transfer. Fertil Steril. 1999;72(5):830-6.
- Speroff L, Fritz MA. Clinical gynecologic endocri-nology and infertility. 7th Edition. Philadelphia: Lippin-cott Williams & Wilkins. 2005: 1248.
- Shearman R, Garret W. Double-blind study of 17-hydroxy progesterone caproate on abortion rate. Br Med J. 1963;2(2):292-5.
- Johnson J, Austin K, Jones G, Davis G, King TM. Efficacy of 17-α-hydroxy progesterone caproate in the prevention of Premature labor. N Eng1 J Med. 1975; 293(4):675-80.
- Hendrickx A, Korte R, Leushener B, Neumann BW, Poggel A, Blinkerd P. et al. Embryotoxicity of sex steroidal hormones in nonhuman primates: 17α Hyd-roxyprogesterone caproate. Estradiol valerate. Terato-logy. 1987;35(3):129-36.
- Abate A, Brigandi A, Abate FG, Balzano E, Perino M. 17-alpha-Hydroxy progesterone caproate and natural progesterone in assisted reproduction :a comparative study. Clin Exp Obstet Gynecol. 1997;24(4):190-2.
- Unfer V, Casini ML, Costabile L, Gerli S, Baldini D, Di Renzo GC. 17alpha-hydroxy progesterone caproate versus intravaginal progesterone in IVF-embryo trans-fer cycles: a Prospective randomized study. Reprod Biomed Online. 2004;9(1):17-21.
- Abate A, Brigandi A, Abate FG, Manti F, Unfer V, Perino M. Luteal phase support with17alpha-hydroxy Progesterone versus unsupported cycles in invitro fertilization: a comparative randomized study. Gynecol Obstet Invest. 1999;48(2):78-80.
- Propst AM, Hill JA, Ginsburg ES, Hurwitz S, Politch J, Yanushpolsky EH. A randomized study comparing Crinone 8% and intramuscular progesterone supple-mentation in in vitro fertilization-embryo transfer cycles. Fertil Steril. 2001;76(6):1144-9.
- Prietl G, Diedrich K, Van der Ven HH, Luckhaus J, Krebs D. The effect of 17 alpha-hydroxyprogesterone caproate/ oestradiol valerate on the development and outcome of early pregnancies following in vitro ferti-lization and embryo transfer: a prospective and rando-mized controlled trial. Hum Reprod.1992;7 Suppl 1:1-5.
- Gorkemil H, Ak D, Akyurek C, Aktan M, Duman S. Comparison of pregnancy outcomes of progesterone or progesterone estradiol for luteal phase support in ICSI-ET cycles. Gynecol Obstet Invest. 2004;58(3):140-4.
- Ludwig M, Diedrich K. Evaluation of an optimal luteal phase support protocol in IVF. Acta Obstet Gynecol Scand. 2001;80(5):452-66.