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. 2024 Jun;41(6):1577-1584.
doi: 10.1007/s10815-024-03118-5. Epub 2024 Apr 27.

Impact of dydrogesterone use in cycles with low progesterone levels on the day of frozen embryo transfer

Jose Metello  1 , Claudia Tomás  2 , Pedro Ferreira  3 , Isabel Natário  4 , Samuel Santos-Ribeiro  5
Affiliations

Impact of dydrogesterone use in cycles with low progesterone levels on the day of frozen embryo transfer

Jose Metello et al. J Assist Reprod Genet. 2024 Jun.

Abstract

Purpose: This study aims to evaluate whether the clinical outcomes of cycles with frozen embryo transfer (FET) in hormonal replacement treatment supplemented with dydrogesterone (DYD) following detection of low circulating levels of progesterone (P4) were comparable to the results of cycles with otherwise normal serum P4 values.

Methods: Extended analyses of a retrospective cohort that included FET cycles performed between July 2019 and March 2022 after a cycle of artificial endometrial preparation using valerate-estradiol and micronized vaginal P4 (400 mg twice daily). Whenever the serum P4 value was considered low on the morning of the planned transfer, 10 mg of DYD three times a day was added as a supplement. Only single-embryo transfers of a blastocyst were considered. The primary endpoint was live birth rate.

Results: Five-hundred thirty-five FET cycles were analyzed, of which 136 (25.4%) underwent treatment with DYD. There were 337 pregnancies (63%), 207 live births (38.6%), and 130 miscarriages (38.5%). The P4 values could be modeled by a gamma distribution, with a mean of 14.5 ng/ml and a standard deviation of 1.95 ng/ml. The variables female age on the day of FET, ethnicity, and weight were associated with a variation in the serum P4 values. There were no differences in the results between cycles with or without the indication for DYD supplementation.

Conclusions: Live birth rate did not vary significantly in females with low and normal serum P4 levels on the day of FET when DYD was used as rescue therapy.

Keywords: Artificial cycle; Dydrogesterone; Frozen embryo transfer; Luteal phase; Supplementation.

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Figures

Fig. 1
Fig. 1
Variation of P4 level according to weight and ethnicity
Fig. 2
Fig. 2
Results observed according to the P4 value on the FET
Fig. 3
Fig. 3
Conditional density plot of P4 value (ng/ml) on the transfer day
See this image and copyright information in PMC

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