# The Impact of Progesterone Administration Routes on Endometrial Receptivity and Clinical Outcomes in Assisted Reproductive Technology Cycles

## TL;DR

This study found no significant difference in endometrial receptivity or pregnancy outcomes between different progesterone administration methods in IVF treatments.

## Contribution

The study provides evidence that progesterone delivery route does not significantly impact ART outcomes, suggesting a need to focus on other factors affecting endometrial receptivity.

## Key findings

- No significant differences in endometrial receptivity states between oral/vaginal and intramuscular progesterone.
- Clinical outcomes like pregnancy and implantation rates were similar across both progesterone administration routes.
- The study suggests that enhancing endometrial receptivity through other means may be more impactful than changing progesterone delivery methods.

## Abstract

Introduction

Assisted reproductive technologies (ART) rely on endometrial receptivity (ER) for successful embryo implantation. This study aimed to compare the impact of different progesterone administration routes on ER assessed using optimal time for endometrial receptivity analysis (OpERA) and clinical outcomes in ART cycles.

Methods

A retrospective cohort analysis was conducted on 281 infertile women who underwent in vitro fertilization (IVF). Patients were stratified based on progesterone administration routes: oral and vaginal progesterone (Group 1) vs. intramuscular progesterone (Group 2). OpERA was performed on 257 patients to assess ER. Clinical outcomes, including biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), implantation rate (IR), and abortion rate (AR), were compared between the groups.

Results

OpERA results showed no significant differences between Group 1 and Group 2 in receptive (51.2% vs. 52.0%, p = 0.857), pre-receptive (44.1% vs. 44.6%, p = 0.933), or post-receptive (4.7% vs. 3.1%, p = 0.496) states. Clinical outcomes, including BPR (59.9% vs. 60.9%, p = 0.903), CPR (50.0% vs. 56.5%, p = 0.463), IR (52.5% vs. 55.3%, p = 0.748), and AR (44.3% vs. 45.6%, p = 0.882), did not significantly differ between the groups.

Conclusion

Progesterone administration routes did not significantly affect ER or clinical outcomes, highlighting the need to prioritize understanding and enhancing ER instead of solely focusing on progesterone delivery methods. Identifying molecular pathways or biomarkers could improve receptivity and optimize ART, ultimately improving pregnancy outcomes.