Patient experience in a randomized trial of a weekly progesterone vaginal ring versus a daily progesterone gel for luteal support after in vitro fertilization

Women undergoing in vitro fertilization reported the vaginal progesterone ring offered less interference with daily activities and sexual activity and the gel was less difficult to apply.

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Volume 110, Issue 6, Pages 1101–1108.e3

Authors:

Elizabeth S. Ginsburg, M.D., Teru Jellerette-Nolan, Ph.D., Gaurang Daftary, M.D., M.B.A., Yunling Du, Ph.D., Kaylen M. Silverberg, M.D.

Abstract:

Objective

To assess patient experience and convenience of using progesterone vaginal ring (VR) versus vaginal gel for women requiring luteal phase support during in vitro fertilization (IVF).

Design

Post hoc analysis of a prospective, randomized, single-blind, multicenter, phase 3 clinical trial.

Setting

Twenty-two U.S. IVF centers.

Patient(s)

Women undergoing IVF (N = 1,297).

Intervention(s)

Randomization to weekly VR or daily gel the day after egg retrieval for up to 10 weeks, with fresh embryo transfer IVF per site-specific procedures.

Main Outcome Measure(s)

Patient satisfaction questionnaire completed at final study visit.

Result(s)

In the women who were taking ≥1 dose of either VR (n = 647) or gel (n = 650), >97% reported that learning to use the formulation, remembering to take it at the correct time, and using it as prescribed was “easy” or “somewhat easy.” More VR than gel users reported noninterference with daily activity (93.3% vs. 74.7%, P<.001), sexual comfort (80.3% vs. 67.8%, P<.001), and sexual desire (73.8% vs. 61.8%, P<.001), as well as not being bothered during sexual intercourse (66.9% vs. 39.2%, P<.001). More gel than VR users reported no difficulty with application (97.4% vs. 80.9%, P<.001). Among women who had previously used progesterone during IVF, more VR users than gel users preferred their currently assigned treatment to their previous treatment (91.4% vs. 83.0%, P=.03).

Conclusion(s)

Weekly progesterone VR and daily progesterone gel were easy to use, with limited impact on quality of life. Overall, the VR appeared to interfere less with daily life, social activities, and sexual activity although the gel was less difficult or stressful to apply.

Clinical Trial Registration Number

NCT00615251.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

1 Comments

Go to the profile of Alexander Quaas
Alexander Quaas almost 2 years ago

Based on findings of this study, a vaginal ring for progesterone supplementation could be an important innovation in IVF treatment cycles.

Can the authors comment when physicians and patients can expect for it to become available in the US? 

Thank you,

Alex Quaas