Comparison of oral dydrogesterone with suppository vaginal progesterone for luteal-phase support in in vitro fertilization [IVF]: a randomized clinical trial

ABSTRACT

Luteal phase support is mandatory in assisted reproductive technologies [ART] for optimizing outcome, so the luteal phase is supported with either progesterone, addition of estradiol to progesterone, hCG or gonadotropin releasing hormone [GnRH] agonists. Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. To compare oral dydrogestrone with vaginal progesterone for luteal-phase support in IVF. We performed this prospective, randomized trial in a tertiary infertility care unit in Taleghani Hospital, Tehran, Iran. In total 80 Women with a history of male factor infertility undergoing controlled ovarian stimulation for IVF treatment [fresh cycle] randomly were divided in two groups [group A or oral dydrogesterone group and group B or vaginal progesterone group]. The inclusion criteria were the use of GnRH analogue down-regulation and age less than 40 years old with regular menstrual cycles. All women were euthyroid and normoprolactinemic. Group A [n=40] received 10 mg dydrogesterone QID [40mg daily] and group B [n=40] received 400 mg suppository vaginal progesterone [cyclogest] twice per day [800 mg daily]. Clinical pregnancy rate in cyclogest group was higher than dydrogesterone group but the difference was not significant [p=0.52], furthermore the miscarriage rate in two group was the same .The difference between two groups regarding antral follicle, embryo number, luteal-phase duration, endometrial thickness, oocyte number and metaphase-II was not significant [p>0.05]. The results showed that oral dydrogesterone is as effective as vaginal progesterone for luteal-phase support in women undergoing IVF