Vaginal use of micronized progesterone for luteal support.A randomized study comparing Utrogestan® and Crinone® 8%

Abstract

Background and Objective. Luteal phase physiology is distorted by in vitro fertilization (IVF) cycles using gonadotropin-releasing hormone (GnRH) agonists and antagonists, Controlled ovarian hyperstimulation leads to luteal phase defect and for this reason, luteal phase support is now an integral part of IVF/ICSI-ET programs. The support is provided by hCG, progesterone or GnRH-a. This study compared the efficiency, safety and tolerance of two vaginal micronized progesterones, Utrogestan and Crinone 8%. Methods. 111 women, 18-40 years old, FSH < 10 IU/L and normal uterus findings were included. The efficiency of the two preparations to provide luteal support was evaluated by the fertilization, implantation, pregnancy and take-home baby rates. The safety was compared through the results of vaginal findings and vaginal inflammation markers before and after treatment. Comparison of tolerance was made by evaluating 21 subjective patient questionnaire parameters.Results. There were no significant differences between the preparations in terms of efficiency or safety though Crinone 8% was better tolerated. Conclusion. The outcomes of this study suggest that a vaginal gel with micronized progesterone (Crinone 8%) is the optimal choice at this time for luteal support.

Adding Weekly Intramuscular Progesterone to a Twice Daily Vaginal Progesterone Capsule for Luteal Phase Support in IVF/ICSI Cycles Results in Similar Live Birth Rates

“…Additionally, there were similar live birth between both groups, 237 (24%) in the Cyclogest group and 46 (26%) in the Cyclogest and the IMP progesterone group. Progesterone has been used traditionally for luteal phase support in cycles of assisted reproduction, and resulted in higher live birth rates in comparison to placebo ( Gün et al ., 2016 ; Jabara et al ., 2009 ; Doblinger et al ., 2016 ; Michnova et al ., 2017 ), and shows less ovarian hyper-stimulation as compared to hCG for luteal phase support ( Baker et al ., 2014 ; Zaman et al ., 2017 ).…”

Clinical Re-evaluation on Bioequivalence and Relative Bioavailability of Micronized Progesterone Hard Capsule (Yimaxin) and Micronized Progesterone Soft Capsule (Utrogestan) under Vaginal and Oral Administration Routes

“…[5][6][7][8] A comparative experiment between Crinone and Utrogestan found that Crinone was better tolerated than Utrogestan, but there were no significant differences in efficiency and safety. 9 The comparison between dydrogesterone and micronized progesterone…”

“… 5 - 8 A comparative experiment between Crinone and Utrogestan found that Crinone was better tolerated than Utrogestan, but there were no significant differences in efficiency and safety. 9 The comparison between dydrogesterone and micronized progesterone showed that both could reduce vascular resistance in patients with recurrent abortion and were effective in improving uterine blood flow. 10 Compared with intramuscular progesterone and oral relative bioavailability was about 10% of intramuscular progesterone.…”

Progesterone loaded thermosensitive hydrogel for vaginal application: Formulation and in vitro comparison with commercial product

“…The applicator is designed to deliver a pre-measured dose of the gel directly into the vagina. This gel showed an efficacy comparable to intramuscular formulations, achieving a stable endometrial PGT concentration with low serum levels, while reducing adverse systemic effects (Michnova et al, 2017, Silverberg et al, 2012, Moini et al, 2011, Wang et al, 2015). The carrier vehicle is an oil-in-water emulsion.…”