Modulating fertility outcome in assisted reproductive technologies by the use of dydrogesterone.
The aim of the present study was to evaluate dydrogesterone for luteal-phase support in assisted reproductive technologies (ART) and to compare it with micronized vaginal progesterone. All patients underwent long-term downregulation with gonadotropin-releasing hormone agonists. In phase I, 498 patients were divided into three groups: long protocol and not at risk of ovarian hyperstimulation syndrome (OHSS) (group A); long protocol and at risk of OHSS (group B); and those in a donor oocyte program (group C). All patients received micronized progesterone 600 mg/day, vaginally. They were also randomized to dydrogesterone 20 mg/day (n = 218) or placebo (n = 280). The pregnancy rate was higher with dydrogesterone than with placebo in group A (33.0% vs. 23.6%), group B (36.8% vs. 28.1%) and group C (42.9% vs. 15.6%; p < 0.001). In phase II, 675 patients were divided into the same three groups (groups D, E and F) and were randomized to dydrogesterone 30 mg/day (n = 366) or micronized progesterone 600 mg/day (n = 309). The pregnancy rate was significantly higher with dydrogesterone than with progesterone in group D (39.1% vs. 26.7%; p < 0.01), group E (41.2% vs. 35.6%; p < 0.01) and group F (48.2% vs. 33.9%; p < 0.001). In conclusion, dydrogesterone is effective in luteal-phase support in ART.
Patki
Ameet
A
ReGenesis, Centre for Assisted Reproduction, Endoscopy & Foetal Medicine, Reliance Life Sciences, Mumbai, India. ameet_patki@relbio.com
Pawar
Vijay C
VC
D004394:Dydrogesterone / Q000008:administration & dosage*; D005260:Female; D005298:Fertility / Q000187:drug effects*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects; D016471:Ovarian Hyperstimulation Syndrome; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage*; D011372:Progestins / Q000008:administration & dosage*; D027724:Reproductive Techniques, Assisted
D011372:Progestins; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004394:Dydrogesterone