Progesterone administration is used in IVF cycles because of the belief that at the time of egg retrieval subsequent progesterone production would be deficient due to the removal of the cells in ovarian follicles responsible for secreting progesterone. Traditionally progesterone has been given as a shot in the buttocks.
Many fertility centers in an effort to appear more ‘patient friendly’ give progesterone vaginally either has a suppository or as an applicator filled progesterone cream. But are shots more effective for fertility medication? There are advantages and disadvantages to each method of delivery. Injections can be painful and vaginal progesterone can be inconvenient, messy and cause irritation in some women. Each IVF program appears to have its own ‘favorite’ method of progesterone delivery that they are comfortable in recommending. Some programs champion being what they believe is more ‘patient friendly’ by giving progesterone vaginaly rather than by injection. But, which method is best? Results from several studies suggest that pregnancy outcomes are similar between the two methods. Still others insist that they have higher rates with one form over the other.
The Fertility Centers of New England uses intramuscular progesterone because of its ability to reduce uterine contractions more so than can be achieved using vaginal applicator creams or suppositories. Uterine relaxation resulting from progesterone shots also reduces the chance of displacement of transferred embryos. We recommend progesterone in oil for luteal support in all of our fresh IVF cycles and in our frozen embryo transfer (FET) cycles. Our over 50% pregnancy success rates in both our fresh and frozen cycles attests to which method of progesterone administration we believe is best and high pregnancy success rates are the epitome of being patient friendly.