AccScience Publishing / IMO / Volume 2 / Issue 4 / DOI: 10.36922/IMO025310037
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ORIGINAL RESEARCH ARTICLE

Intramuscular progesterone and frozen embryo transfer outcomes: A multicenter prospective evaluation of the clinical relevance of serum progesterone monitoring

Vipin Chandra1 ,  Matheus Roque2 ,  Kshitiz Murdia3 ,  Nitiz Murdia4 ,  Shashank V. Sanagoudar3* ,  Nagadeepti Naik5 ,  Shipra Nigam6 ,  Anjali Gahlan7 ,  Walmik Mistari8 ,  Isha Suwalka9 ,  Nihar Ranjan Bhoi3 ,  Ankita Saha10,11 ,  Korhan Cengiz12 ,  Saurav Mallik13,14*
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1 Department of Clinical and Lab Operations, Indira IVF Hospital Pvt Ltd., Udaipur, Rajasthan, India
2 Department of Reproductive Medicine, Huntington, São Paulo, Brazil
3 Department of Reproductive Medicine, Indira IVF Hospital Pvt Ltd., Udaipur, Rajasthan, India
4 Department of Embryology, Indira IVF Hospital Pvt Ltd, Udaipur, Rajasthan, India
5 Department of Reproductive Medicine, Indira IVF Hospital Pvt Ltd., Vashi, Maharashtra, India
6 Department of Reproductive Medicine, Indira IVF Hospital Pvt Ltd., Shahdara, Delhi, India
7 Department of Reproductive Medicine, Indira IVF Hospital Pvt Ltd., Allahabad, Uttar Pradesh, India
8 Indira IVF Hospital Pvt Ltd, Udaipur, Rajasthan, India
9 Research and Publications, Indira IVF Hospital Pvt Ltd., Udaipur, Rajasthan, India
10 Department of Computer Science, Swami Vivekananda University, Barrackpore, West Bengal, India
11 Department of Management and Technology, ABS Academy of Science, Technology and Management, Durgapur, West Bengal, India
12 Department of Electrical Engineering, College of Engineering, Prince Mohammad Bin Fahd University, Al Khobar, Eastern Province, Saudi Arabia
13 Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
14 Department of Pharmacology and Toxicology, University of Arizona, Tucson, Arizona, United States of America
IMO 2025, 2(4), 93–101; https://doi.org/10.36922/IMO025310037
Received: 1 August 2025 | Revised: 2 September 2025 | Accepted: 10 October 2025 | Published online: 14 November 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

The progesterone concentration in endometrial tissue after using vaginal progesterone supplementation is significantly higher than that with IM progesterone administration, whereas; serum progesterone levels are approximately four times higher with IM progesterone compared with vaginal administration. Therefore, serum progesterone cut-off points will differ according to the route of progesterone administration. This study aims to assess the association between serum progesterone levels on the day of frozen embryo transfer (FET) and pregnancy outcomes in artificial FET cycles. This multicenter prospective cohort study, conducted at different centers of Indira IVF Hospitals across India, included 353 women aged 21–40 years who underwent hormone replacement therapy-based FET cycles with intramuscular (IM) progesterone administered up to the day of embryo transfer. The mean serum progesterone level was 31.36 ± 13.78 ng/mL. Participants were categorized into quartiles based on serum progesterone levels: Q1 (<21.7 ng/mL), Q2 (21.7–28.1 ng/mL), Q3 (28.2–40.0 ng/mL), and Q4 (≥40.0 ng/mL). No significant differences in ongoing pregnancy rate (OPR), clinical pregnancy rate (CPR), first-trimester miscarriage rates, or live birth rate (LBR) were observed across the quartiles. Binary logistic regression revealed no statistically significant differences in OPR among the quartiles. Our findings suggest that serum progesterone levels do not significantly influence clinical outcomes, including OPR, CPR, and LBR, in patients undergoing artificial FET cycles with IM progesterone support.

Keywords
Serum progesterone
Frozen embryo transfer
In vitro fertilization
Ongoing pregnancy
Live birth rate
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Innovative Medicines & Omics, Electronic ISSN: 3060-8740 Print ISSN: 3060-8910, Published by AccScience Publishing
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