The following is a summary of “Individualized luteal phase support using additional oral dydrogesterone in artificially prepared frozen embryo transfer cycles: is it beneficial?,” published in the June 2023 issue of Reproductive BioMedicine Online by Mackens et al.
Does oral dydrogesterone supplementation enhance reproductive outcomes in patients with low serum progesterone levels on the day of frozen embryo transfer (FET) following artificial (HRT) endometrial preparation? About 694 unique patients undergoing a single blastocyst transfer in an HRT cycle were included in a retrospective, single-center cohort study. Intravaginal micronized vaginal progesterone (MVP, 400 mg twice daily) was administered for luteal phase support.
Patients with average serum progesterone concentrations (≥8.8 ng/ml) continuing the routine protocol were compared with patients with low serum progesterone concentrations (<8.8 ng/ml) who received additional oral dydrogesterone supplementation (10 mg 3 times daily) beginning the day after FET. The primary outcome was the live birth rate (LBR), with relevant confounders accounted for by a multivariate regression model. Around 547/694 (78.8%) of patients who continued only MVP as planned had average serum progesterone concentrations, whereas 147/694 (21.2%) of patients who received additional oral dydrogesterone supplementation on top of MVP from the day after FET onwards had low (<8.8 ng/ml) serum progesterone concentrations.
LBR was comparable between the two groups: 37.8% for MVP alone and 38.2% for MVP+OD (P = 0.84). According to the multivariate logistic regression model, LBR was not significantly associated with the investigated approaches (adjusted odds ratio 1.01, 95% CI 0.69–1.44, P = 0.97). Current findings indicate that oral dydrogesterone supplementation in patients with low serum progesterone concentrations at the transfer time may improve reproductive outcomes in HRT–FET cycles. However, the lack of randomized controlled trials impedes progress in this study area.