I’m a little confused on the uptake of progesterone during the 2ww. In a previous question, your feedback: “There are different ways of administering the progesterone and this is mostly industry and market driven, as numerous randomised trials have shown all to be of equal efficacy with the exception of oral administration which has been shown to be not sufficient.” A friend just had a failed IVF and it was suggested that she should use POI shots instead of peccaries next time round with her FET. Why isn’t POI’s prescribed in the first place? Why risk the possibility of under absorption if it can be prevented with PIOs? It seems common sense that intra muscular uptake would be better than transvaginal.Friday, June 13th, 2008
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 -