Comparison between different routes of progesterone administration as luteal phase support in infertility treatments.
In order to study the feasibility and efficacy of using natural 17 beta-estradiol (E2) and progesterone (P) to induce endometrial changes, a group of patients with history of premature ovarian failure and bilateral oophorectomy, also interested in the embryo transfer program with donor ovum, were given transdermal E2 (Estraderm, Ciba Pharmaceutical Co., Summit, NJ), and vaginal progesterone suppositories. Serial serum E2, P, follicle-stimulating hormone, and luteinizing hormone were determined by radioimmunoassays. The dosages of E2 and P were adjusted according to the levels of E2 and P so that their changes could follow the same pattern as that of a normal spontaneous menstrual cycle. Serial ultrasonic evaluation of the endometrium and endometrial biopsy during the late luteal phase also was performed. Preliminary data indicated that transdermal E2 patches and vaginal P suppositories, while being as effective in inducing endometrial development for the embryo transfer procedure with donor ovum as synthetic steroids, can also provide a more physiologic approach that may conveniently and safely be extended into the second trimester of pregnancy.