Additional Dydrogesterone Use Improves the Adverse Perinatal Outcomes during Low Progesterone Levels by Use of Micronized Vaginal Progesterone Alone
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0518
- VernacularTitle:联合使用地屈孕酮改善阴道微粒化黄体酮时低孕酮水平的不良围产结局
- Author:
Yan-xin XIE
1
;
Hai-yan LIN
1
;
Jia HUANG
1
;
Xiao-li CHEN
1
;
Qing-xue ZHANG
1
;
Yu LI
1
Author Information
1. Reproductive Center， Department of Obstetrics and Gynecology， Sun Yat-sen Memorial Hospital， Sun Yat-sen University， Guangzhou 510220， China
- Publication Type:Journal Article
- Keywords:
progesterone （P4）;
live birth rate （LBR）;
frozen embryo transfer （FET）， hormone replacement therapy cycles （HRT）
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(5):837-844
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore whether the impact of low serum progesterone （P4） levels on the adverse pregnancy outcomes could be improved by the additional use of oral dydrogesterone （DYG） during the single use of micronized vaginal progesterone （MVP） for luteal phase support in hormone replacement therapy frozen embryo transfer （HRT-FET） cycles. MethodsIn this retrospective study， the clinical and perinatal outcomes of HRT-FET cycles using MVP alone （n=549） and MVP combined with DYG （n=495） were analyzed. The primary outcome was live birth rate （LBR）， and the secondary outcomes were clinical pregnancy rate （CPR）， gestational weeks （GW） at delivery， and perinatal birth weight （BW）. ResultsThe elevated serum P4 level on the day of pregnancy test was a protective factor for live birth. In the group using MVP alone， compared with the high serum P4 concentration （≥7.46 ng/mL）， the low serum P4 concentration （<7.46 ng/mL） was closely associated with low LBR （25.6% vs. 40.7%， P < 0.001）， CPR （34.6% vs. 50.1%， P < 0.001）， rates of full-term birth （FTB） （18.6% vs. 32.6%， P =0.003） and normal birth weight （NBW） （17.9% vs. 34.4%， P <0.001）. Compared with the group using MVP alone， combined use of MVP and DYG did not significantly improve LBR （38.3% vs. 40.6%， P=0.366）， but significantly increased the mean GW at delivery （37.28±3.01 vs. 38.36±1.48 weeks； P=0.043）， the neonatal NBW rate （18.2% vs. 27.6%； P=0.039） and decreased the proportion of low BW and very low BW （LBW+VLBW） infants （7.7% vs. 2.2%； P=0.037）. ConclusionAdditional use of DYG could significantly increase the GW at delivery and NBW rate， decrease the LBW+VLBW rates and thereby improve the adverse perinatal outcomes induced by low serum P4 levels （<7.46 ng/mL） in the HRT-FET cycles using MVP alone.
