Vaginal (Crinone 8%) gel vs. intramuscular progesterone in oil for luteal phase support in in vitro fertilization: a large prospective trial.

OBJECTIVE To compare the efficacy of intravaginal and IMP for luteal phase support in IVF cycles. DESIGN Prospective trial. SETTING Tertiary care private practice. PATIENT(S) Women 25-44 years old with infertility necessitating treatment with IVF. From April 1, 2008-April 1, 2009, 511 consecutive patients were enrolled; 474 completed participation, and 37 were excluded for no autologous ET (freeze all, donor recipients, failed fertilization/cleavage). There were no demographic differences between the two treatment groups. INTERVENTION(S) Luteal phase support using either Crinone or P in oil starting 2 days following oocyte retrieval. MAIN OUTCOME MEASURE(S) Pregnancy and delivery rates stratified by patient age. RESULT(S) Overall, patients who received vaginal P had higher pregnancy (70.9% vs. 64.2%) and delivery (51.7% vs. 45.4%) rates than did patients who received IMP. Patients <35 who received vaginal P had significantly higher delivery rates (65.7% vs. 51.1%) than did patients who received IMP. There were no differences, regardless of age, in the rates of biochemical pregnancy, miscarriage, or ectopics. CONCLUSION(S) In younger patients undergoing IVF, support of the luteal phase with Crinone produces significantly higher pregnancy rates than does IMP. Crinone and IMP appear to be equally efficacious in the older patient.