From the Guidelines
For a 31-year-old female 5 days before going to frozen embryo transfer, the recommended dose of progesterone is 200 mg three times daily (600 mg total daily dose) using suppositories or gel formulations, or 50-100 mg of intramuscular progesterone in oil daily. This recommendation is based on the standard practice of progesterone supplementation to prepare the endometrial lining for embryo implantation and support early pregnancy maintenance 1. The choice between intramuscular and vaginal progesterone depends on patient preference and potential side effects, with vaginal progesterone being a common choice due to its ease of administration and reduced risk of injection site pain. Key considerations include:
- The timing of progesterone supplementation, which typically starts 5-6 days before the scheduled transfer 1.
- The importance of continuing progesterone supplementation through the first 10-12 weeks of pregnancy if the transfer is successful.
- Potential side effects, such as vaginal irritation with suppositories or injection site pain with intramuscular administration, and the need for patients to follow their clinic's specific instructions regarding administration technique. It is essential to note that while the provided study 1 discusses hormonal replacement therapy in adolescents and young women with premature ovarian insufficiency, the principles of progesterone supplementation for frozen embryo transfer are generally applicable, and the recommended doses are consistent with standard practice in assisted reproduction.
From the Research
Progesterone Dosage for Frozen Embryo Transfer
The optimal dosage of progesterone for a 31-year-old female 5 days before undergoing frozen embryo transfer (FET) is not explicitly stated in the provided studies. However, the following points can be considered:
- A study from 2007 2 compared the outcome of frozen-thawed ET cycles using different doses of progesterone for luteal support and found that high-dose progesterone supplementation resulted in a significantly higher clinical pregnancy rate.
- A 2022 pilot randomized controlled trial 3 compared oral, vaginal, or intramuscular progesterone in programmed FET cycles and found that treatment with 40 mg/day oral dydrogesterone, 180 mg/day progesterone vaginal gel, or 100 mg/day intramuscular progesterone revealed similar reproductive outcomes.
- A 2021 randomized clinical trial 4 found that intramuscular progesterone optimized live birth from programmed FET, with a live birth rate of 44% compared to 27% with vaginal progesterone only.
- Key considerations for progesterone supplementation include:
- The dosage and formulation of progesterone
- The timing of progesterone supplementation
- The individual patient's response to progesterone
- The potential for side effects with different formulations and dosages
Relevant Studies
The following studies provide relevant information on progesterone supplementation for FET:
- review of the current literature on FET preparation methods, including the timing of embryo transfer and progesterone supplementation.
- comparison of the outcome of frozen-thawed ET cycles using different doses of progesterone for luteal support.
- pilot randomized controlled trial comparing oral, vaginal, or intramuscular progesterone in programmed FET cycles.
- randomized clinical trial comparing intramuscular progesterone to vaginal progesterone for programmed FET.
- review of the evidence for progesterone supplementation during fresh and frozen embryo transfer, including the rationale, timing, and dosing of progesterone supplementation.