title: Assessment of sub-endometrial blood flow parameters following dydrogesterone and micronized vaginal progesterone administration in women with idiopathic recurrent miscarriage: a pilot study.
abstract: OBJECTIVE
  To evaluate differences in uteroplacental blood flow and pregnancy outcome in women with idiopathic recurrent spontaneous miscarriage (IRSM) following administration of micronized vaginal progesterone and oral dydrogesterone.
  
  
  METHODS
  One hundred and thirty-three women (aged 23-40 years) who had had early miscarriages and spontaneous conception participated. Oral dydrogesterone (group A, n = 51) and micronized vaginal progesterone (group B, n = 50) were administrated for luteal support and compared. Pregnant women without history of recurrent miscarriage served as controls (group C, n = 32). The outcome measures consisted of endometrial blood flow parameters by Doppler indices and ongoing pregnancy rate.
  
  
  RESULTS
  Before progesterone supplementation, resistivity index (RI) and pulsatility index (PI) were found to be significantly higher in groups A and B as compared to controls. Although statistically not significant, end diastolic velocity (EDV) and systolic/diastolic (S/D) ratio was found to be superior in controls than IRSM women. Peak systolic velocity (PSV) was comparable between IRSM and non-IRSM groups. Following progesterone supplementation, groups A and B showed a highly significant reduction in RI, PI and an increase in EDV. A relative increase in the value of PSV was observed in group A as compared to group B. There was remarkable difference in S/D in both groups. Although not statistically significant, group C showed reduction in RI, PI, PSV, EDV and S/D ratio. Pregnancy salvage rates were higher in group A (92.0%) as compared to group B (82.3%).
  
  
  CONCLUSIONS
  Progesterone supplementation appears to lower vascular resistance in women with IRSM. Oral dydrogesterone appears to be equally effective in improving endometrial blood flow as compared with micronized progesterone.
authors: Institute of Reproductive Medicine, Kolkata, West Bengal, India.
authors: Sanghamitra
authors: S
authors: Ghosh
authors: Ratna
authors: R
authors: Chattopadhyay
authors: Sourendrakanta
authors: S
authors: Goswami
authors: Koel
authors: K
authors: Chaudhury
authors: Baidyanath
authors: B
authors: Chakravarty
authors: Ashalatha
authors: A
authors: Ganesh
mesh_terms: D000026:Abortion, Habitual / Q000188:drug therapy*; D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D004339:Drug Compounding; D004394:Dydrogesterone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007194:India; D010865:Pilot Projects; D021041:Placental Circulation / Q000187:drug effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D011372:Progestins / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D016037:Single-Blind Method; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D011372:Progestins; D011374:Progesterone; D004394:Dydrogesterone
keywords: dydrogesterone; endometrial blood flow; endometrial receptivity; idiopathic recurrent miscarriage; micronized vaginal progesterone; progesterone supplementation