Beltsos Angeline N, Sanchez Mark D, Doody Kevin J, Bush Mark R, Domar Alice D, Collins Michael G
Fertility Centers of Illinois, River North Center 900 N Kingsbury, Ste RW6, Chicago, IL, 60610, USA.
Women's Medical Research Group, LLC, Florida Fertility Institute, 2454 McMullen Booth Rd Ste 601, Clearwater, FL, 33759, USA.
Reprod Health. 2014 Nov 11;11:78. doi: 10.1186/1742-4755-11-78.
Administration of exogenous progesterone for luteal phase support has become a standard of practice. Intramuscular (IM) injections of progesterone in oil (PIO) and vaginal administration of progesterone are the primary routes of administration. This report describes the administration preferences expressed by women with infertility that were given progesterone vaginal insert (PVI) or progesterone in oil injections (PIO) for luteal phase support during fresh IVF cycles.
A questionnaire to assess the tolerability, convenience, and ease of administration of PVI and PIO given for luteal phase support was completed by infertile women diagnosed with PCOS and planning to undergo IVF. The women participated in an open-label study of highly purified human menopausal gonadotropins (HP-hMG) compared with recombinant FSH (rFSH) given for stimulation of ovulation.
Most women commented on the convenience and ease of administration of PVI, while a majority of women who administered IM PIO described experiencing pain. In addition, their partners often indicated that they had experienced at least some anxiety regarding the administration of PIO. The most distinguishing difference between PVI and PIO in this study was the overall patient preference for PVI. Despite the need to administer PVI either twice a day or three times a day, 82.6% of the patients in the PVI group found it "very" or "somewhat convenient" compared with 44.9% of women in the PIO group.
The results of this comprehensive, prospective patient survey, along with findings from other similar reports, suggest that PVI provides an easy-to-use and convenient method for providing the necessary luteal phase support for IVF cycles without the pain and inconvenience of daily IM PIO. Moreover, ongoing pregnancy rates with the well-tolerated PVI were as good as the pregnancy rates with PIO.
ClinicalTrial.gov, NCT00805935.
黄体期支持时给予外源性孕酮已成为一种标准做法。肌内注射油剂孕酮（PIO）和经阴道给予孕酮是主要给药途径。本报告描述了接受体外受精-胚胎移植（IVF）新鲜周期黄体期支持时，使用阴道孕酮缓释凝胶（PVI）或油剂孕酮注射（PIO）的不孕女性所表达的给药偏好。
一项关于评估用于黄体期支持的PVI和PIO的耐受性、便利性及给药难易程度的问卷调查由诊断为多囊卵巢综合征（PCOS）且计划接受IVF的不孕女性完成。这些女性参与了一项关于高纯度人绝经期促性腺激素（HP-hMG）与重组促卵泡生成素（rFSH）用于促排卵的开放标签研究。
大多数女性对PVI的便利性和给药容易程度给予评价，而大多数接受肌内注射PIO的女性称有疼痛感。此外，她们的伴侣常表示对PIO的注射至少有些焦虑。本研究中PVI和PIO最显著的差异是患者总体上更偏爱PVI。尽管PVI需要每日给药两次或三次，但PVI组82.6%的患者认为其“非常”或“有些方便”，而PIO组只有44.9%的女性这样认为。
这项全面的前瞻性患者调查结果，以及其他类似报告的研究结果表明，PVI为IVF周期提供必要的黄体期支持提供了一种易于使用且方便的方法，避免了每日肌内注射PIO的疼痛和不便。此外，耐受性良好的PVI的持续妊娠率与PIO的妊娠率相当。
ClinicalTrial.gov，NCT00805935 。
