I would like to ask for your advice regarding the use of progesterone for luteal support. I am getting confused when I search the literature and when I ask my colleagues about their practice. There are several available products like: The progesterone vaginal gel, progesterone vaginal suppositories, the new vaginal ring presented by Teva, progesterone IM, the new progesterone SC coming out by IBSA and the oral formulation by Abbott.
Apart from the new and untested progesterones like the ring, SC and the oral progesterone all the rest giving same clinical results.
Is this correct, what should we use if they all, including the oral would give same good results in pregnancy rates and outcome?
Answer by Dom de Ziegler
In essence, all progesterone preparations available for IM or vaginal use are equivalent as far as efficacy is concerned. Side effects vary of course.
Oral progesterone is not effective in infertility due to the high hepatic metabolism. Is effective in menopause though.Synthetic molecules are better not used. SC progesterone by IBSA is being launched at ESHRE in Europe. Teva's ring I don't know. Both are equally effective, but again with different side effects.
Hope this is helpful
Dom de Ziegler, MD
Professor and Head, Div. Reprod. Endocr. and Infertility
Université Paris Descartes - Hôp. Cochin, Paris, France