Dydrogesterone as an oral alternative to vaginal progesterone for IVF luteal phase support

Autor: Claire Pexman-Fieth, Stefan Driessen, Georg Griesinger, Christophe Blockeel, Elke Kahler, Jan I. Olofsson, Herman Tournaye
Přispěvatelé: Surgical clinical sciences, Reproduction and Genetics, Centre for Reproductive Medicine - Gynaecology, Biology of the Testis
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Pregnancy Rate
Maternal Health
Administration
Oral
Dydrogesterone
Biochemistry
Mathematical and Statistical Techniques
Pregnancy
Medicine and Health Sciences
Oral Administration
Lipid Hormones
Progesterone
Routes of Administration
Multidisciplinary
Obstetrics
Statistics
Obstetrics and Gynecology
Metaanalysis
Embryo transfer
Treatment Outcome
Physical Sciences
Medicine
Gestation
Female
Live birth
Live Birth
Research Article
medicine.drug
medicine.medical_specialty
Science
Fertilization in Vitro
Luteal Phase
Luteal phase
Research and Analysis Methods
Ovulation Induction
Population Metrics
medicine
Humans
Statistical Methods
Pharmacology
Population Biology
business.industry
Biology and Life Sciences
Neonates
Birth Rates
Embryo Transfer
medicine.disease
Hormones
Confidence interval
Administration
Intravaginal
Pregnancy rate
Women's Health
Progestins
business
Mathematics
Developmental Biology
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 11, p e0241044 (2020)
Popis: The aim of this systematic review and meta-analysis was to conduct a comprehensive assessment of the evidence on the efficacy and safety of oral dydrogesterone versus micronized vaginal progesterone (MVP) for luteal phase support. Embase and MEDLINE were searched for studies that evaluated the effect of luteal phase support with daily administration of oral dydrogesterone (20 to 40 mg) versus MVP capsules (600 to 800 mg) or gel (90 mg) on pregnancy or live birth rates in women undergoing fresh-cycle IVF (protocol registered at PROSPERO [CRD42018105949]). Individual participant data (IPD) were extracted for the primary analysis where available and aggregate data were extracted for the secondary analysis. Nine studies were eligible for inclusion; two studies had suitable IPD (full analysis sample: n = 1957). In the meta-analysis of IPD, oral dydrogesterone was associated with a significantly higher chance of ongoing pregnancy at 12 weeks of gestation (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.08 to 1.61; P = 0.0075) and live birth (OR, 1.28; 95% CI, 1.04 to 1.57; P = 0.0214) compared to MVP. A meta-analysis combining IPD and aggregate data for all nine studies also demonstrated a statistically significant difference between oral dydrogesterone and MVP (pregnancy: OR, 1.16; 95% CI, 1.01 to 1.34; P = 0.04; live birth: OR, 1.19; 95% CI, 1.03 to 1.38; P = 0.02). Safety parameters were similar between the two groups. Collectively, this study indicates that a higher pregnancy rate and live birth rate may be obtained in women receiving oral dydrogesterone versus MVP for luteal phase support.
Databáze: OpenAIRE
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