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Dydrogesterone: pharmacological profile and mechanism of action as luteal phase support in assisted reproduction

Published:December 15, 2018DOI:https://doi.org/10.1016/j.rbmo.2018.11.017

      Abstract

      The pharmacological and physiological profiles of progestogens used for luteal phase support during assisted reproductive technology are likely to be important in guiding clinical choice towards the most appropriate treatment option. Various micronized progesterone formulations with differing pharmacological profiles have been investigated for several purposes. Dydrogesterone, a stereoisomer of progesterone, is available in an oral form with high oral bioavailability; it has been used to treat a variety of conditions related to progesterone deficiency since the 1960s and has recently been approved for luteal phase support as part of an assisted reproductive technology treatment. The primary objective of this review is to critically analyse the clinical implications of the pharmacological and physiological properties of dydrogesterone for its uses in luteal phase support and in early pregnancy.

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      Biography

      Georg Griesinger is a Professor at Lübeck University and chair at the Department of Gynecological Endocrinology and Reproductive Medicine at University Hospital of Schleswig-Holstein, Lübeck, Germany. His research interests include endocrinology of ovarian stimulation, evidence-based medicine in reproductive health care, epidemiological studies in IVF, folliculogenesis and cryopreservation of ovarian tissue.
      Key message
      Dydrogesterone is a selective progesterone receptor agonist with high oral bioavailability. These key pharmacokinetic features allow for effective oral administration and may limit the risk of side-effects. Clinical studies have shown that oral dydrogesterone has a good benefit–risk profile, comparable to that of micronized vaginal progesterone, during luteal phase support.