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It is estimated that the sisters who read the topic do not understand, progesterone is not a routine operation after IVF embryo transfer, there are different ways of administration, suppositic drugs, injections can be, does this still have an impact on pregnancy?
Previous studies have suggested that no matter what kind of administration method, it does not affect the success rate of IVF, but the latest study has overturned the previous perception that the success rate may be very different depending on the method of administration.
01Why test tubes need luteal support
We know that embryo transfer is similar to the process of growing crops – planting spring and harvesting autumn – meaning doing the right thing at the right time.
For patients undergoing frozen embryo transfer, if the doctor performs hormone replacement to prepare the lining,
That is to say, the patient himself will not generate the soil suitable for embryo planting,
If fresh embryo transfer is performed, ultra-controlled ovulation induction will advance the time when the "soil" is suitable for planting, causing the embryo implantation time to stagger with the time when the lining accepts the embryo.
, the degree of acceptance of embryos is higher, which is conducive to the embryonic baby "camping".
02 Mainstream luteal administration mode and characteristics
In the IVF process, the commonly used methods of administration mainly include intramuscular administration, vaginal progesterone (cinodone) and oral administration.
Progesterone injection used to be a common drug used by reproductive doctors, because it was favored by doctors and patients.
But as the drug was used for more time, its adverse reactions followed - allergies, local induration is very easy to form, pain at the injection site, many sisters both love and hate.
The main advantage of vaginal progesterone is the "principle of proximity" -
Improves the local progesterone concentration of the uterus and plays a role, is currently in vitro luteal support,
Vaginal progesterone is more convenient to operate, reducing the pain of patients, and according to studies, vaginal progesterone has a lower probability of systemic side effects such as allergic reactions, but the disadvantage is that the price is slightly expensive.
Some people will produce vaginal local irritation symptoms and increased discharge, which will bring a lot of shock and worry to the IVF sisters!
Oral progesterone due to the metabolism of the liver, its, and some oral progesterone use, patients produce obvious and other serious adverse reactions.
In oral progesterone, the adverse reaction is relatively small, and the desdrogesterone,
But it also has a drawback:
According to previous studies, intramuscular progesterone and vaginal progesterone for luteal support did not make significant differences in IVF pregnancy rates and miscarriage rates, and did not affect patients' pregnancy outcomes.
Is this really the case? Let's take a look at the latest scientific data.
03 Fertility and infertility: IVF success rate is affected by luteal support
The study was published by the Third Military Medical University of the Mainland in the top journal of international reproductive medicine, Fertility and Infertility, which is
A total of 6905 cycles of frozen embryos were included in the study, all using hormone replacement resuscitation transplantation regimens, of which 4,616 cycles were administered as vaginal progesterone and 2,289 cycles by intramuscular progesterone.
The aim of the trial was to compare pregnancy outcomes such as HCG positivity, live birth rate, and miscarriage rate with different modes of administration.
The results showed that the live birth rate of the vaginal progesterone group was 46.23%, and the live birth rate of the intramuscular progesterone group was 48.62%, which was higher than that of the vaginal progesterone group, and there was a statistically significant difference between the two groups.
In terms of HCG positivity, 69% in the vaginal progesterone group and 67.85% in the intramuscular progesterone group
In terms of clinical pregnancy rate, 61.59% in the vaginal progesterone group and 60.03% in the intramuscular progesterone group
In terms of HCG positivity and clinical pregnancy rates,
In terms of miscarriage rate, 15.34% in the vaginal progesterone group and 11.40% in the intramuscular progesterone group.
In terms of total pregnancy loss rate, 22.22% in the vaginal progesterone group and 18.90% in the intramuscular progesterone group
So
Why is this happening? We looked at the subgroup analysis to find out why.
In data comparing different modes of administration in women of different weights, the researchers found that
while overweight or obese women are heavy,
In conclusion, this study tells us,
Through this latest research, the circle sister still
Although its shortcomings are very obvious, isn't the ultimate purpose of our test tube to get pregnant and hold a baby?
Even if you are an obese patient, its pregnancy success rate is not lower than that of vaginal medication, but the price is a fraction of that of vaginal medication.
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bibliography
[1] Overweight and obesity affect the efficacy of vaginal vs. intramuscular progesterone for luteal-phase support in vitrified-warmed blastocyst transfer. Fertil Steril. 2023 Apr;119(4):606-615. doi: 10.1016/j.fertnstert.2022.12.034. Epub 2022 Dec 22. PMID: 36567035.