The meaning of a randomised controlled trial is that during the trial, 2 subjects are run head to head and the results analysed as to which is the best. There is no difference in the absorption between intra muscular and vaginal progesterone at all – this has been proven numerous times. So therefore, common sense does not prevail in this instance. It is up to the attending physician in consultation with the patient to decide which form of progesterone supplementation will be used to support the luteal phase. Most people would prefer not to have a painful injection, one that is not without side effects I might add, if there is a less invasive and proven equally effective method such as vaginal pessaries in the correct dose.
With regards to your friend as mentioned in the question: We have a very similar case in the clinic at the moment and the only reason why we have decided to change to the injectable progesterone is because the discharge that follows the insertion of the pessary is socially not acceptable to her.
- Week 16 answers kindly provided by Dr. Stephan Volschenk -