A comparative study of dydrogesterone and micronized progesterone for luteal phase support during in vitro fertilization (IVF) cycles

Abstract

The aim of the present study was to compare the efficacy, tolerability and patients’ satisfaction after the use of oral dydrogesterone with vaginal micronized progesterone for luteal-phase support (LPS) among infertile women undergoing in vitro fertilization (IVF). A total of 210 women (aged 20–40 years old) with a history of infertility, who underwent controlled ovarian stimulation for fresh intra-cytoplasmic sperm injection-embryo transfer cycles, were included in the study. Consequently, they were randomized to receive LPS with dydrogesterone 20 mg twice daily (n = 96) or micronized progesterone 400 mg twice daily at the day of oocyte retrieval (n = 114). The clinical success rate (31% versus 33%; p = 0.888), miscarriage rate (5.0% versus 3.0%; p = 0.721), ongoing pregnancy rate (30.0% versus 30.0%; p = 1.000), implantation (22.0% versus 24.0%; p = 0.254) and multiple pregnancy rate (5.30% versus 7.20%; p = 0.394) were comparable among the two groups. Serum progesterone levels were significantly lower among the patients receiving dydrogesterone than the control group (13.62 ± 13.83 ng/ml versus 20.66 ± 18.09 ng/ml; p = 0.001). However, there was no statistically significant difference regarding the patients’ satisfaction (p = 0.825) and tolerability (0.790) between the two groups. Our results showed that oral dydrogesterone (40 mg/day) is as effective as vaginal micronized progesterone considering its clinical outcomes and patients’ satisfaction and tolerability, for LPS among women undergoing IVF.

Chinese abstract

本研究的目的在于比较IVF周期中接受口服地屈孕酮和阴道给予微粒化黄体酮对于黄体支持（luteal-phase support, LPS）的效果、耐受性及患者满意度。研究共纳入210名有不孕史的女性（年龄20-40岁），她们都进行了控制性卵巢刺激后单精子卵胞浆内显微注射，并进行了胚胎移植。从取卵日起，患者被随机给予每日2次20mg地屈孕酮（n = 96）或阴道给予每日2次400mg微粒化黄体酮（n = 114）。两组的临床成功率（31% versus 33%，p = 0.888），流产率（5.0% versus 3.0%，p = 0.721），持续妊娠率（30.0% versus 30.0%，p = 1.000），种植率（22.0% versus 24.0%，p = 0.254）及多胎妊娠率（5.30% versus 7.20%，p = 0.394）相当。服用地屈孕酮的患者血清中孕酮水平显著低于对照组患者（13.62 ± 13.83 ng/ml versus 20.66 ± 18.09 ng/ml，p = 0.001）。但是，两组间患者满意度（p = 0.825）及耐受性（p =0.790）没有显著差异。研究表明，在临床结局、患者满意度及耐受性方面，口服地屈孕酮（40mg/天）与阴道给予微粒化黄体酮对于接受IVF治疗的女性的LPS效果相当。

• Dydrogesterone
• in vitro fertilization
• luteal-phase support
• micronized progesterone
• progesterone

Acknowledgements

We would like to thank Miss Masoumeh Yazdan Ashouri and Farzaneh Hoseini for their assistance.

Declaration of interest

The authors report no conflicts of interest.