Abstract
Research question
: Does additional supplementation with oral dydrogesterone (OD) improve reproductive
outcomes in patients with low serum progesterone (P) levels on the day of frozen embryo
transfer (FET) after artificial (HRT) endometrial preparation?
Design
: This is a retrospective, single-centre cohort study including 694 unique patients
performing single blastocyst transfer in an HRT cycle. For luteal phase support, intravaginal
micronized vaginal progesterone (MVP, 400mg twice daily) was administered. Serum P
levels were assessed prior to FET and outcomes were compared among patients with normal
serum P (≥ 8,8 ng/ml) continuing the routine protocol and patients with low serum
P (<8,8 ng/ml) who received additional OD supplementation (10mg three times daily)
from the day after FET onwards. Primary outcome was live birth rate (LBR) with a multivariate
regression model correcting for relevant confounders.
Results
: Normal serum P levels were observed in 547/694 (=78.8%) of patients who continued
only MVP as planned, whereas low (<8.8ng/ml) serum P levels were detected in 147/694
(=21.2%) patients who received additional OD supplementation on top of MVP from the
day after FET onwards. LBR was comparable between both groups: 37.8% for MVP-only
versus 38.8% for MVP+OD (p=0.84). The multivariate logistic regression model indicated
that LBR was not significantly associated with the investigated approaches (OR 1.01,
CI 0.69-1.47, p=0.97).
Conclusions
: The current findings suggest that additional OD supplementation in patients with
low serum P levels at the moment of transfer could have the potential to rescue reproductive
outcomes in HRT-FET cycles. This field of research, however, remains hampered by the
absence of randomized controlled trials.
Key words
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Biography
Mackens Shari - biosketch: Shari Mackens (MD, PhD) is a gynecologist and medical director at the Centre for Reproductive Medicine (Brussels IVF) at the UZ Brussel, Belgium. She is a clinical professor at the Vrije Universiteit Brussel (VUB) with a specific interest in translational research focusing on the role of the endometrium in ART.
Article info
Publication history
Accepted:
February 17,
2023
Received in revised form:
February 15,
2023
Received:
November 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
