ABSTRACT
Objectives: To compare the efficacy and tolerance of two vaginal progesterone formulations (micronized capsules and pessaries) as luteal phase support after successful ovulation induction in patients with polycystic ovarian syndrome. Design: Randomized comparative study. Setting: Infertility clinic of Woman's Health Center, Assiut University. Patients and methods: 120 women diagnosed as polycystic ovarian syndrome and responded to successful ovulation induction by a minimal stimulation protocol, were enrolled in the study from August 2007 to April 2008. Progesterone was administered after ultrasound evidence of ovulation until menstruation occurred or up to 12th weeks if patients got pregnant. Patients were randomly divided into two equal groups to receive either of the two compounds. The first group received micronized progesterone capsules (2×100 mg twice/day) and the second group received progesterone pessaries (200 mg twice /day). Progesterone level, endometrial thickness, occurrence of clinical pregnancy, ongoing pregnancy and patient's tolerance were assessed. Pregnancy was confirmed by serum HCG estimation and 6 weeks gestation ultrasound. Results: Mid-luteal progesterone level was significantly higher in the second group. Thin endometrium was more encountered significantly higher in the first group. There was no significant difference between the occurrence of pregnancy and ongoing pregnancy in both groups. Patient's tolerance and satisfaction were significantly higher in the second group. Conclusion: Micronized progesterone capsules were equally effective as vaginal progesterone pessaries for supporting luteal phase and early pregnancy in patients with polycystic ovarian syndrome. Patients were more satisfied with vaginal progesterone pessaries because of easier application and minimal side effects.
Key words: Luteal phase support, vaginal micronized progesterone, progesterone pessaries, polycystic ovarian syndrome.