Comparative assessment of the efficacy of micronized progesterone medications in the IVF programs

Ovarian stimulation in the in vitro fertilization (IVF) programs is accompanied by a defect in the luteal phase of the cycle, therefore hormonal support after embryo transfer into the uterine cavity is an integral part of the treatment. Vaginal administration is the most common route for the progesterone delivery.

Objective: To compare efficacy and tolerability of two forms of vaginal micronized progesterone, namely capsules (Utrogestan, Besins Healthcare) and gel (Miragel, Vertex JSC), in the IVF programs.

Materials and methods: The study included 309 patients: the patients of the first group (n=154) received micronized progesterone in the form of a vaginal gel at a dose of 90 mg per day, the patients of the second group (n=155) were administered micronized progesterone in capsules 200 mg 3 times a day vaginally. Efficacy was assessed using the following parameters: clinical pregnancy rate, early pregnancy loss rate, live birth rate. The medication tolerability was compared using the assessment of the patients’ questionnaires.

Results: Clinical pregnancy rate in the first group was 59.1%, and it was 55.2% in the second group; early pregnancy loss rate was 14.2% and 15.1%, respectively; live birth rate in the first group was 49.4%, and it was 45.2% in the second group. There were no statistically significant differences between the groups. The rate of premature births in the first group was 0%, and it was 7.1% in the second group. According to the patients’ survey, micronized progesterone in the form of a gel was better tolerated.

Conclusion: The comparative assessment of the vaginal administration of micronized progesterone in the form of gel and capsules demonstrated high efficacy of the medication. The vaginal gel was better tolerated and more convenient for the patients, according to the survey. Miragel can be administered to support the luteal phase in the IVF programs.