Hypersensitivity to progesterone-in-oil after in vitro fertilization and embryo transfer

Objective: To report the occurrence and management of pulmonary compromise, marked leukocytosis, and eosinophilia in a patient receiving P-in-oil after IVF and embryo transfer. Design: Case report. Setting: A tertiary referral reproductive medicine unit. Patient(s): A 29-year-old patient receiving P-in-oil supplementation after IVF embryo transfer. Intervention(s): Extensive diagnostic testing and surveillance for hypersensitivity to P in sesame oil; development of an alternative oil-based P-in-oil suspension. Main Outcome Measure(s): Tolerance of alternative P vehicle; clinical pregnancy. Result(s): The patient tolerated an alternative P oil vehicle and successfully achieved a clinical pregnancy after frozen embryo transfer. Conclusion(s): Although rare, hypersensitivity reactions may occur in patients receiving P-in-oil supplementation after IVF embryo transfer. Testing for tolerance and subsequent use of alternative P vehicles may be an effective strategy in managing patients with sensitivity to P-in-oil.