title: Live birth rates and safety profile using dydrogesterone for luteal phase support in assisted reproductive techniques.
abstract: BACKGROUND
  Assisted reproductive techniques (ARTs) result in a deficient luteal phase, requiring the administration of intramuscular, intravaginal or oral exogenous progesterone. Dydrogesterone, an oral retroprogesterone with good bioavailability, has been used in assisted reproductive cycles with outcomes that are comparable to those of vaginal or intramuscular progesterone. However, there are limited reviews on its use for luteal phase support in ARTs, in terms of pregnancy outcomes and associated fetal anomalies. This study aimed to review the live birth rates and associated fetal anomalies of women who were given dydrogesterone for luteal phase support in assisted reproductive cycles at a tertiary hospital in Singapore.
  
  
  METHODS
  This retrospective descriptive study included 1,050 women who underwent in vitro fertilisation/intracytoplasmic sperm injection at the Centre for Assisted Reproduction of Singapore General Hospital between 2000 and 2011. The women were given dydrogesterone for luteal phase support. The main outcome measures were rates of pregnancy, live birth, miscarriage and fetal anomalies.
  
  
  RESULTS
  The pregnancy and live birth rates were 34.7% and 27.7%, respectively. Among those who achieved pregnancy, 17.0% miscarried, 0.8% had ectopic pregnancies and 0.3% had molar pregnancies. Fetal anomalies were detected in 1.9% of pregnancies, all of which were terminated by choice.
  
  
  CONCLUSIONS
  Since the outcomes of dydrogesterone are comparable to those of intramuscular and vaginal progesterone, it is a reasonable option to provide luteal phase support for women who are uncomfortable with injections or vaginal insertions. Randomised controlled studies are needed to determine the optimal dosage of dydrogesterone for luteal phase support in ARTs.
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.
authors.forename: Ravichandran
authors.initials: R
authors.lastname: Nadarajah
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.
authors.forename: Hemashree
authors.initials: H
authors.lastname: Rajesh
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.
authors.forename: Ker Yi
authors.initials: KY
authors.lastname: Wong
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.
authors.forename: Fazlin
authors.initials: F
authors.lastname: Faisal
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.
authors.forename: Su Ling
authors.initials: SL
authors.lastname: Yu
mesh_terms: D000328:Adult; D001723:Birth Rate; D004394:Dydrogesterone / Q000627:therapeutic use*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects*; D008875:Middle Aged; D011372:Progestins / Q000627:therapeutic use*; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011372:Progestins; D004394:Dydrogesterone
keywords: dydrogesterone; fetal anomalies; live birth; luteal phase support; pregnancy