Comparison Between Oral Dydrogesterone versus Intravaginal Micronized Progesterone Gel in Clinical Outcome within the First HRT-FET Cycle: A Retrospective Analysis

Abstract

Abstract Objective The purpose of this study is to compare the clinical efficacy of oral dydrogesterone and intravaginal micronized progesterone gel during the first HRT-FET cycle. Methods A retrospective cohort study based on a total of 344 women undergoing their first HRT-FET cycles without Gonadotropin-Releasing Hormone agonist (GnRH-a) pretreatment was conducted. All the cycles were allocated to two groups in the reproductive medical center at the University of Hong Kong-Shenzhen Hospital. One group (n = 193) received oral dydrogesterone 30mg/d before embryo transfer, while the other group (n = 151) received intravaginal micronized progesterone gel 180mg/d. Results The demographics and baseline characteristics of two groups were comparable. We found no statistically significant difference in live birth rate (24.35% vs. 31.13%, P = 0.16), clinical pregnancy rate (34.72% vs. 36.42%, P = 0.74), embryo implantation rate (25.09% vs. 28.36%, P = 0.43), positive pregnancy rate (42.49% vs 38.41%, P = 0.45), or ectopic pregnancy rate (0.52% vs. 0.66%, P = 0.86) between the oral dydrogesterone group and micronized vaginal progesterone (MVP) gel group. In the multivariate logistic regression analysis for covariates, medication used for luteal support was not associated with live birth rate (OR = 0.74, 95% CI: 0.46–1.21, P = 0.23). And the different luteal support medication did not have a significant positive association with the live birth rate in the cycles with day 2 embryo transferred (OR = 0.73, 95% CI:0.34–1.54, P = 0.41) and blastocyst transferred (OR = 0.75, 95% CI:0.36–1.57, P = 0.45). Conclusion This study demonstrates that oral dydrogesterone is a viable alternative to intravaginal micronized progesterone gel in luteal phase support (LPS) during the first HRT-FET cycle.