vaginal progesterone
4 Replies
newjourney - March 7

Can you please tell me the advantages and disadvantages to progesterone in oil vs progesterone vaginal suppositories, in terms of sucess rates.
We have no female factors except I am 37yrs old.
This is the first time I have ever tried to get pregnant and are only going through ICSI because my husband need to use sperm from a testicular biopsy since he has hypoplastic vas deferens. Would I be stimulated enough with just the suppositories after my embryo transfer.
Thanks

 

B. Jacobs, M. D. - March 7

The "gold standard" for progesterone supplement in IVF is still progesterone in oil. I am too much of a coward to stop prescribing it. Vaginal progesterone provides good tissue levels in the endometrium, without a significant blood level. Since I am a devout coward, I prescribe both.
Good luck.

 

newjourney - March 8

I am also an MD and I understand why sometimes I feel the need for CYA, however I wanted to know if there are any double blinded trials that show one is better than the other especially when there are no female factors that we know of except for maternal age.
If there are good tissue levels in the endometrium does one need good blood levels. Or in your personal practice experience have you had good sucess with women who have opted for only the vaginal suppositories. Lastly is there any good reasons that prog in oil would be contraindicated by vag suppositories would not be.
Thanks

 

newjourney - March 8

For example , cerebral angiography is the "gold standard" to exclude berry aneurysms but I would be satisfied with a good quality MRI with todays technology
-Thanks again
Sonia

 

B. Jacobs, M. D. - March 8

As I said, I am a devout coward, and have not abandoned IM progesterone in oil. There are data that vaginal progesterone, in the form of Crinone provide good tissue levels. You might see the work of William Gibbons, M. D. when he was at East Virginia Medical College.

 

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