Prospective randomized trial to evaluate the efficacy of a vaginal ring releasing progesterone for IVF and oocyte donation (PDF)
Zegers-Hochschild,F.; Balmaceda,J.P.; Fabres,C.; Alam,V.; Mackenna,A.; Fernandez,Emilio; Pacheco,I.M.; Sepulveda,M.S.; Chen,S.; Borrero,C.; Borges,E.
Human Reproduction 15(10): 2093-2097
Publication date: 2000
A polysyloxane vaginal ring containing 1g of natural progesteronewas developed as luteal supplementation for women treated withIVF-embryo transfer and for agonadal women participatingin an oocyte donation programme. The ring provides continuousrelease of progesterone (10-20 nmol/l) for 90 days. The efficacyof this form of progesterone supplementation was evaluated intwo multicentre prospective randomized trials. IVF-embryotransfer trial: After oocyte aspiration, 505 women were randomlyallocated to progesterone supplementation with vaginal ringor i.m. progesterone (50 mg/day). The clinical pregnancy ratewas 36.6% in both groups. Implantation rate was 15.9% in thevaginal ring and 16.0% in i.m. progesterone. Oocyte donationtrial: After endometrial proliferation with micronized oestradiol,153 women were allocated to progesterone replacement with avaginal ring or i.m. progesterone (100 mg/day). Clinical pregnancyrate was 39.8 and 28.6% respectively. Implantation rate wassignificantly higher with the vaginal ring compared with i.m.progesterone (19.9 and 11.6% respectively, P = 0.006). The vaginalring is a novel development which provides continuous releaseof progesterone for 90 days. In IVF-embryo transfer, itseffectiveness is similar to daily i.m. injections. In oocytedonation the ring provides a progestative milieu which improvesthe implantation rate and eliminates the discomfort of dailyi.m. injections.