Vaginal progesterone luteal phase support may improve pregnancy outcomes during intrauterine insemination cycles

Abstract EN

-Aim: To determine the impact of luteal phase support using vaginal progesterone on pregnancy outcomes in infertile couples scheduled for intrauterine insemination when ovulation induction was attempted using recombinant follicle stimulating hormone. Methods: This was a prospective randomized study done in the infertility unit, Armed Forces Hospital Southern Region, Kingdom of Saudi Arabia and included 71 patients with either primary or secondary infertility who fulfilled the inclusion criteria.

All these patients underwent intrauterine insemination as a treatment for their infertility.

After randomization, 37 patients started their cycles as supported while the remaining 34 started by non supported cycles.

In supported cycles, patients received vaginal progesterone (Crinone© 8°/o,Serono) once daily starting from the day following insemination and continued for 14 days.

No progesterone was given for non supported cycles.

During the second cycle crossover occurred and this process continued till the end of the study.

The main outcome measures were the clinical pregnancy rate and the live birth rate per cycle and per patient.

*٠ Results: 132 supported intrauterine insemination cycles and 126 non supported cycles were performed successfully.

The clinical pregnancy rate per patient was higher in supported than in non supported cycles (54.92% versus 35.21%, respectiv^y, p =0.016), while per cycle this difference could not he detected (29.54% versus 19.84%, respectively, p =0.07).

Twenty five pregnancies in supported cycles and 7 in non supported cycles ended by live births and when these rates were compared per cycle and per patient, significant difference was detected between both types of cycles (18.9% and 35.2% versus 5.5% and 9.8%, p =0.001, and <0.001, respectively).

Conclusion: Luteal phase support using vaginal progesterone improved the success of intrauterine insemination cycles when recombinant follicle stimulating hormone was used for ovulation induction.