Exogenous progesterone-induced acute urticaria in association with in vitro fertilisation

Exogenous progesterone aids in enhancing embryo implantation and consequently pregnancy rates, which makes it crucial for both establishing and sustaining pregnancy during in vitro fertilisation (IVF) treatment. Hypersensitivity reaction following administration of progesterone is a rare adverse drug reaction. We present the case of a woman in her early 30s with primary infertility who presented with a generalised itchy rash since the evening before admission. The patient had generalised wheals on examination. The day before her admission, as part of her IVF procedure, she had taken progesterone. The diagnosis of exogenous progesterone-induced acute urticaria was made by de-challenging and then re-challenging the suspected drug after all other possible explanations had been ruled out. The patient was given symptomatic treatment, which led to the subsiding of the reaction. She was followed up periodically and did not observe a recurrence of the rash. She conceived in this treatment cycle and delivered a healthy child.