Abstract
Objective
The purpose of this study was to compare the clinical outcomes of single oral dydrogesterone with vaginal progesterone gel plus oral dydrogesterone in GnRH antagonist cycles with fresh embryo transfer.
Methods
This study retrospectively analyzed 658 treatment cycles of fresh embryo transfer cycle with GnRH antagonist protocol from 2015 to 2020 in the Reproductive Medicine Center of the University of Hong Kong-Shenzhen Hospital. Each cycle was the first fresh stimulation cycle of the patients. The study group included 368 cycles with 30 mg oral dydrogesterone daily, while the control group included 290 cycles with 90 mg of progesterone vaginal gel and 20 mg oral dydrogesterone daily. Propensity score matching was carried out to adjust for numerical differences and to balance between the two groups. After propensity, totally 231 cycles in each group remained and were retrospectively analyzed.
Results
After matching, the demographics and baseline characteristics of two groups were comparable. There was no significant difference were found in clinical pregnancy rate (35.498%versus 35.498%, P = 1), embryo implantation rate (47.613%vs. 49.352%,P = 0.710), live birth rate (26.407%versus 28.139%, P = 0.676), miscarriage rate (19.512%versus15.854%, p = 0.539), multiple birth rate (2.165%versus 1.732%,P = 0.736), OHSS rate (0.433%versus 0.433%, P = 1) and ectopic pregnancy rate (2.165%versus 1.299%, P = 0.476) between the oral dydrogesterone group (study group) and the vaginal progesterone gel combined with dydrogesterone group (control group).
Conclusion: In conclusion, single oral dydrogesterone and dydrogesterone combined with vaginal progesterone gel revealed similar reproductive outcomes in GnRH antagonist cycles with fresh embryo transfer in the study. And single use of dydrogesterone minimized patient inconvenience and reduced the incidence of adverse effects. It could be the new choice for the luteal phase support in the fresh GnRH antagonist cycle.