23
Views
5
CrossRef citations to date
0
Altmetric
Original Article

Transvaginal progesterone supplementation increases serum insulin-like growth factor-binding protein-1 levels

&
Pages 349-355 | Published online: 07 Jul 2009
 

Abstract

The objective of this study was to assess the effect, which might be mediated by progesterone-dependent insulin-like growth factor-binding protein-1 (IGFBP- 1), of micro-nizedprogesterone supplementation through different administration routes (oral or vaginal) on successful pregnancy. A total of 299 anovulatory women were treated with clomiphene citrate (100 mg/day on days 5–9 of the menstrual cycle) to stimulate follicular growth. Human chorionic gonadotropin (liCG, 10 000 IV) was injected intramuscularly when at least one follicle was > 20 mm in diameter as monitored by transvaginal ultrasonography. Micronizedprogesterone (300 mg/day, at bedtime) was used as supplementation of progesterone randomly by oral (n = 153) or vaginal (n = 146) administration from approximately 36-48 h after hCG administration until the following menstrual period or the 10th week of gestation from the last menstrual period. As a control, 18 apparently healthyfemales with at least three regular menstrual cycles immediately before the present study were also recruited but no interventions were made. Serum levels of progesterone, IGFBP-1, insidin-like growth factor-1 (IGF-I) and insulin were determined on day 8 after hCG administration (day 0 indicates the day of hCG administration; progesterone supplementation group) or on day 21 of the menstrual cycle (controls). In the midluteal phase higher progesterone and lower IGFBP-1 levels were observed in the serum from patients supplemented with oral progesterone than in those using vaginal progesterone. Total and continuing pregnancy rates were also higher in the patients using oral than in those using vaginal progesterone (p < 0.04, by the zl-test). However, there was no difference in serum IGF-I or insulin level between the groups. It was concluded that oral administration of micronized progesterone at bedtime appears to be a convenient method of luteal supplement, whereas vaginal supplementation during the luteal phase might directly stimulate endometrial production of IGFBP-1, which possibly, in turn, deters embryo implantation and results in a decrease in the pregnancy rate.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.