Comparable Outcomes Using Oral Dydrogesterone Vs. Micronized Vaginal Progesterone in Frozen Embryo Transfer: a Retrospective Cohort Study

Atzmon, Yuval; Aslih, Nardin; Estrada, Daniela; Bilgory, Asaf; Ellenbogen, A.; Shalom-Paz, Einat

doi:10.1007/s43032-020-00376-3

Cited by 17 publications

(13 citation statements)

References 32 publications

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“…A total of 180 participants (9.1%) had a biochemical pregnancy, which was de ned as a positive βhCG test result with no pregnancy on ultrasound. A biochemical pregnancy was con rmed in 11.8% of participants treated with dydrogesterone, and this rate was higher than the 3-5% reported in previous studies (23,24). This may be due to variability in ovarian stimulation protocols.…”

Section: Discussionmentioning

confidence: 54%

Evaluation of allylestrenol for clinical pregnancies in patients treated with assisted reproductive techniques: a retrospective, propensity score matched, observational study

Ding³

et al. 2022

Preprint

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Background: Allylestrenol is an oral progestogen being increasingly used for luteal phase support (LPS) inassisted reproductive techniques. However, evidence of the clinical efficacy of allylestrenol in LPS is lacking. Dydrogesterone is a representative drug used for LPS, the efficacy of which has been clinically confirmed. As such, we aimed to compare the effects of allylestrenol with the standard dydrogesterone on clinical pregnancy rates and pregnancy outcomes. Methods: This retrospective study included 3375 assisted reproductive technique cycles using either allylestrenol or dydrogesterone between January 2015 and March 2020. Patients using either allylestrenol or dydrogesterone were matched in a 1:1 ratio using propensity scores. The primary outcomes were clinical pregnancy rate and pregnancy outcomes. Results: No significant difference was found in the clinical pregnancy rate (54.4% vs.53.7%, P = 0.787) and pregnancy outcomes (all P > 0.05) between allylestrenol and dydrogesterone. Compared with dydrogesterone, the use of allylestrenol significantly reduced the rate of biochemical pregnancies (6.4% vs.11.8%, P < 0.001) and multiple gestation rate (16.8% vs.26.3%, P = 0.001). Moreover, endometrial thickness, morphology, and blood flow were significantly improved by allylestrenol treatment (all P < 0.05). Conclusions: Allylestrenol exhibited similar effects on clinical pregnancy rates and pregnancy outcomes as dydrogesterone. Moreover, allylestrenol had a more positive impact on biochemical pregnancy and endometrial receptivity.

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Section: Discussionmentioning

confidence: 54%

Evaluation of allylestrenol for clinical pregnancies in patients treated with assisted reproductive techniques: a retrospective, propensity score matched, observational study

Ding³

et al. 2022

Preprint

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“…In FET cycles, one prospective study showed that luteal phase support with oral dydrogesterone added to vaginal progesterone had a higher live birth rate and lower miscarriage rate compared with vaginal progesterone alone (20). In a retrospective study, MVP gel alone was demonstrated to be non-inferior to oral dydrogesterone alone in FET cycles (21). In one single-blind randomized controlled trial, oral progesterone was compared to intramuscular progesterone and intravaginal progesterone (22).…”

Section: Discussionmentioning

confidence: 99%

Comparable Outcomes Using Oral Dydrogesterone versus Intramuscular Progesterone in Frozen Embryo Transfer: a Retrospective Cohort Study

Bachar

Haskia

Fainaru

2023

Preprint

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Background Optimal intensive luteal support in frozen embryo transfer (FET) cycles in which a corpus luteum is not present has not been determined and several treatment regimens are currently practiced. Previous reports suggest that vaginal progesterone alone is probably insufficient. The use of intramuscular progesterone is considered efficacious but much less tolerable. The objective of this study was to compare a more tolerable regimen using micronized vaginal progesterone (MVP) and oral dydrogesterone versus MVP and intramuscular progesterone (IM) for luteal support. Methods A retrospective study of patients undergoing single blastocyst FET in a tertiary center IVF unit. All patients (n = 100) received oral estradiol in the follicular phase and supplemented with MVP for luteal phase support. One group (n = 50) received additional dydrogesterone (10 mg TID) and the other (n = 50) intramuscular progesterone (100 mg every 3 days). Results The two groups were similar with regard to age; BMI; infertility etiology and duration; and basal hormonal levels. Biochemical pregnancy rates (34% vs 42%, p = 0.54) and clinical pregnancy rates (26% vs. 36%, p = 0.39) were lower in the MVP + oral dydrogesterone group as compared to the MVP + IM progesterone group. Nevertheless, this difference was not statistically significant. Abortion rates were similar (2%) and there were no ectopic pregnancies in both groups. Conclusion This retrospective cohort study demonstrates noninferiority of MVP and oral dydrogesterone as compared to MVP and intramuscular progesterone for luteal support in FET cycles. The better profile of adverse effects and tolerability makes it a suitable protocol for FET.

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Section: Discussionmentioning

confidence: 99%

“…Conversely, we opted to use DYD after taking into consideration several clinical trial that evaluated the efficacy of its oral form in luteal phase support, both in fresh and frozen transfers. 11,16,17,26,[31][32][33][34][35][36][37] The cut-off used for DYD administration was set according to a previous evaluation of our own population which corresponds to 11.5% of the pool of the cycles. 28 However, when compared to other series, 18,19 the P4 distribution in our population seems to be much higher.…”

Section: Discussionmentioning

confidence: 99%

The Addition of Dydrogesterone after Frozen Embryo Transfer in Hormonal Substituted Cycles with Low Progesterone Levels

Metello

Tomás²,

Ferreira

et al. 2022

Rev Bras Ginecol Obstet

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Objective To determine whether a rescue strategy using dydrogesterone (DYD) could improve the outcomes of frozen embryo transfer cycles (FET) with low progesterone (P4) levels on the day of a blastocyst transfer. Methods Retrospective cohort study including FET cycles performed between July 2019 and October 2020 following an artificial endometrial preparation cycle using estradiol valerate and micronized vaginal P4 (400 mg twice daily). Whenever the serum P4 value was below 10 ng/mL on the morning of the planned transfer, DYD 10 mg three times a day was added as supplementation. The primary endpoint was ongoing pregnancy beyond 10 weeks. The sample was subdivided into two groups according to serum P4 on the day of FET: low (< 10 ng/mL, with DYD supplementation) or normal (above 10 ng/mL). We performed linear or logistic generalized estimating equations (GEE), as appropriate. Results We analyzed 304 FET cycles from 241 couples, 11.8% (n = 36) of which had serum P4 below 10 ng/mL on the FET day. Baseline clinical data of patients was comparable between the study groups.Overall, 191 cycles (62.8%) had a biochemical pregnancy, of which 131 (44,1%) were ongoing pregnancies, with a 29,8% miscarriage rate. We found no statistically significant differences in the hCG positive (63 vs 64%) or ongoing pregnancy rates (50 vs 43,3%) between those FETs with low or normal serum P4 values, even after multivariable logistic regression modelling. Conclusion Our results indicate that DYD 10 mg three times a day administered in women who perform FET with P4 serum levels < 10 ng/mL, allows this group to have pregnancy rates beyond 12 weeks at least as good as those with serum levels above 10 ng/mL.

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Comparable Outcomes Using Oral Dydrogesterone Vs. Micronized Vaginal Progesterone in Frozen Embryo Transfer: a Retrospective Cohort Study

Cited by 17 publications

References 32 publications

Evaluation of allylestrenol for clinical pregnancies in patients treated with assisted reproductive techniques: a retrospective, propensity score matched, observational study

Evaluation of allylestrenol for clinical pregnancies in patients treated with assisted reproductive techniques: a retrospective, propensity score matched, observational study

Comparable Outcomes Using Oral Dydrogesterone versus Intramuscular Progesterone in Frozen Embryo Transfer: a Retrospective Cohort Study

The Addition of Dydrogesterone after Frozen Embryo Transfer in Hormonal Substituted Cycles with Low Progesterone Levels

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