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Background <p>This study evaluates the effectiveness of oral dydrogesterone (DYD) for luteal phase support on pregnancy outcomes in patients undergoing frozen embryo transfer with natural cycle protocols (NC-FET), compared with micronized vaginal progesterone (MVP) and combined therapy.</p> Methods <p>A retrospective study analyzed 2,035 NC-FET cycles, including both natural and modified natural cycles, conducted between January 2019 and August 2022. A total of 2,035 NC-FET cycles were analyzed. Participants were categorized into three groups based on luteal phase support regimens: Group A (699 cycles) received oral DYD, Group B (433 cycles) received MVP, and Group C (903 cycles) received combination therapy. The live birth rates and neonatal outcomes were compared among the groups.</p> Results <p>The live birth rates were comparable across the groups (43.8%, 39.0%, and 42.1%; <i>P</i> &gt; 0.05). No significant variations were found in clinical pregnancy rate, spontaneous miscarriage rate, ectopic pregnancy rate, premature birth rate, and newborn birth weights. Embryo implantation rates in Groups A and C were significantly higher than in Group B (44.1% and 42.9% vs. 37.8%; <i>P</i> = 0.029). Multi-factor regression analysis identified several independent variables influencing the live birth rate, but luteal support regimens did not significantly impact live birth rates (<i>P</i> &gt; 0.05).</p> Conclusion <p>In NC-FET cycles, oral DYD demonstrates clinical efficacy comparable to MVP and combined medication. As a monotherapy, oral DYD expands therapeutic options, offering a convenient and effective choice to improve adherence and achieve similar pregnancy outcomes. This finding is significant for guiding clinical practices towards optimal treatment strategies that prioritize patient compliance and satisfaction.</p>

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Comparison of oral dydrogesterone and vaginal progesterone for luteal phase support in natural and modified natural cycle frozen embryo transfers

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月14日

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  • Yan-xin Xie,
  • Lin-lin Jiang,
  • Jia Huang,
  • Lin Li,
  • Qi Qiu,
  • Ping Pan,
  • Yu Li

摘要

Background

This study evaluates the effectiveness of oral dydrogesterone (DYD) for luteal phase support on pregnancy outcomes in patients undergoing frozen embryo transfer with natural cycle protocols (NC-FET), compared with micronized vaginal progesterone (MVP) and combined therapy.

Methods

A retrospective study analyzed 2,035 NC-FET cycles, including both natural and modified natural cycles, conducted between January 2019 and August 2022. A total of 2,035 NC-FET cycles were analyzed. Participants were categorized into three groups based on luteal phase support regimens: Group A (699 cycles) received oral DYD, Group B (433 cycles) received MVP, and Group C (903 cycles) received combination therapy. The live birth rates and neonatal outcomes were compared among the groups.

Results

The live birth rates were comparable across the groups (43.8%, 39.0%, and 42.1%; P > 0.05). No significant variations were found in clinical pregnancy rate, spontaneous miscarriage rate, ectopic pregnancy rate, premature birth rate, and newborn birth weights. Embryo implantation rates in Groups A and C were significantly higher than in Group B (44.1% and 42.9% vs. 37.8%; P = 0.029). Multi-factor regression analysis identified several independent variables influencing the live birth rate, but luteal support regimens did not significantly impact live birth rates (P > 0.05).

Conclusion

In NC-FET cycles, oral DYD demonstrates clinical efficacy comparable to MVP and combined medication. As a monotherapy, oral DYD expands therapeutic options, offering a convenient and effective choice to improve adherence and achieve similar pregnancy outcomes. This finding is significant for guiding clinical practices towards optimal treatment strategies that prioritize patient compliance and satisfaction.