Combination treatement for IVF patients may eliminate vaginal bleeding

A prospective, multi-center study demonstrated that in IVF (in vitro fertilization) cycles supplemented with once-daily dosing of Crinone® vaginal progesterone gel and Estrace® oral estrogen, vaginal bleeding is rare in patients who become pregnant. Bleeding does occur in approximately one-quarter of patients who do not become pregnant. These data were presented at the American Society for Reproductive Medicine (ASRM) annual meeting in Atlanta.

Vaginal bleeding is reported in some IVF cycles during the luteal phase (the end of a woman’s menstrual cycle, when progesterone levels are significantly higher), and can be a major concern for women undergoing infertility treatment. This study, including 66 patients who became clinically pregnant and 53 patients who did not conceive, evaluated the effectiveness of the combination of Crinone with estrogen on luteal phase bleeding.

In a podium presentation, James P. Toner, MD, PhD, Atlanta Center for Reproductive Medicine, demonstrated that 36% of patients had spotting or bleeding associated with egg retrieval. No more than two (5%) of the pregnant patients bled on any day past egg retrieval. The combination of vaginal progesterone gel and estrogen appears to reduce the incidence of bleeding in IVF patients who become pregnant.

“By treating IVF patients with a combination of Crinone and Estrace, we may succeed in eliminating bleeding in those who achieve pregnancy and reduce the level of stress and concern for patients during this stage of their treatment cycle,” stated Dr. Toner. “We are continuing to collect data, including data from other centers that use either intramuscular progesterone or do not supplement their Crinone cycles with estradiol, to determine if bleeding rates are different with these other strategies for luteal support.”

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