Objective:To compare the clinical outcomes of single oral dydrogesterone with vaginal progesterone gel plus oral dydrogesterone in gonadotropin-releasing hormone (GnRH) antagonist cycles with fresh embryo transfer.Methods:This study retrospectively analyzed 658 treatment cycles of fresh embryo transfer cycle with GnRH antagonist protocol from December 2015 to December 2020 in the Center of Reproductive Medicine of the University of Hong Kong-Shenzhen Hospital. Each cycle was the first fresh stimulation cycle of the patients. The patients were divided into two groups according to different luteal support regimens. Group A included 368 cycles with a regimen of 30 mg dydrogesterone tablets orally daily, while group B included 290 cycles with a regimen of 90 mg vaginal progesterone gel vaginally daily combined with 20 mg dydrogesterone tablets orally daily. A 1∶1 propensity score matching (PSM) was carried out to adjust for numerical differences and to balance between the two groups, and further they were divided into cleavage stage embryo transfer cycles and the blastocyst transfer cycles according to the different type of embryo for layer analysis, and the laboratory results and assisted reproductive outcomes of the two groups were compared.Results:After matching, the baseline characteristics were comparable between the two groups, with 251 cycles remaining in each group for retrospective analysis. After PSM, statistically significant differences were observed between group A and group B in laboratory data including the number of fertilized oocytes [5 (2, 7) vs. 6 (3, 9), P=0.002], cleavage rate [100.0% (86.31%, 100.0%) vs. 87.28% (75.32%, 100.0%), P<0.001], and available embryo rate [80.18% (54.64%, 100.0%) vs. 67.48% (50.62%, 100.0%), P=0.019]. However, there were no significantly statistical differences in other laboratory data and clinical outcomes (all P>0.05). If we divided the data into two comparison according to the different type of embryo, there were no significantly statistical differences in clinical pregnancy rate, embryo implantation rate, live birth rate, miscarriage rate, multiple pregnancy rate, ovarian hyperstimulation syndrome incidence, and ectopic pregnancy rate neither in day 2 cleavage stage embryo transfer cycles nor in the blastocyst transfer cycles. Conclusion:In this study, the clinical outcomes are similar between taking 30 mg of dydrogesterone tablets orally alone and taking 20 mg of dydrogesterone tablets orally combined with vaginal progesterone gel in the fresh embryo transfer cycle of the GnRH antagonist protocol. Moreover, taking dydrogesterone tablets orally alone can be a new option for luteal support in the fresh cycle of the GnRH antagonist protocol.

Objective:To compare the clinical outcomes of single oral dydrogesterone with vaginal progesterone gel plus oral dydrogesterone in gonadotropin-releasing hormone (GnRH) antagonist cycles with fresh embryo transfer.Methods:This study retrospectively analyzed 658 treatment cycles of fresh embryo transfer cycle with GnRH antagonist protocol from December 2015 to December 2020 in the Center of Reproductive Medicine of the University of Hong Kong-Shenzhen Hospital. Each cycle was the first fresh stimulation cycle of the patients. The patients were divided into two groups according to different luteal support regimens. Group A included 368 cycles with a regimen of 30 mg dydrogesterone tablets orally daily, while group B included 290 cycles with a regimen of 90 mg vaginal progesterone gel vaginally daily combined with 20 mg dydrogesterone tablets orally daily. A 1∶1 propensity score matching (PSM) was carried out to adjust for numerical differences and to balance between the two groups, and further they were divided into cleavage stage embryo transfer cycles and the blastocyst transfer cycles according to the different type of embryo for layer analysis, and the laboratory results and assisted reproductive outcomes of the two groups were compared.Results:After matching, the baseline characteristics were comparable between the two groups, with 251 cycles remaining in each group for retrospective analysis. After PSM, statistically significant differences were observed between group A and group B in laboratory data including the number of fertilized oocytes [5 (2, 7) vs. 6 (3, 9), P=0.002], cleavage rate [100.0% (86.31%, 100.0%) vs. 87.28% (75.32%, 100.0%), P<0.001], and available embryo rate [80.18% (54.64%, 100.0%) vs. 67.48% (50.62%, 100.0%), P=0.019]. However, there were no significantly statistical differences in other laboratory data and clinical outcomes (all P>0.05). If we divided the data into two comparison according to the different type of embryo, there were no significantly statistical differences in clinical pregnancy rate, embryo implantation rate, live birth rate, miscarriage rate, multiple pregnancy rate, ovarian hyperstimulation syndrome incidence, and ectopic pregnancy rate neither in day 2 cleavage stage embryo transfer cycles nor in the blastocyst transfer cycles. Conclusion:In this study, the clinical outcomes are similar between taking 30 mg of dydrogesterone tablets orally alone and taking 20 mg of dydrogesterone tablets orally combined with vaginal progesterone gel in the fresh embryo transfer cycle of the GnRH antagonist protocol. Moreover, taking dydrogesterone tablets orally alone can be a new option for luteal support in the fresh cycle of the GnRH antagonist protocol.

Objective To compare the clinical efficacy of luteal phase support with oral dydrogesterone tablets and vaginal progester-one gel combined with oral dydrogesterone tablets during hormone replacement therapy-frozen embryo transfer(HRT-FET).Methods A retrospective analysis was conducted on a total of 489 cycles which underwent HRT-FET at the Center of Reproductive Medicine,the University of Hong Kong-Shenzhen Hospital from November 2018 to June 2022.There were 226 cycles underwent with oral dydrogester-one tablets as luteal support,and 263 cycles underwent with vaginal progesterone gel combined with oral dydrogesterone tablets as luteal support.The primary observation index was the delivery rate.The pregnancy outcomes of HRT-FET in the two groups were compared and analyzed,and the related factors were analyzed.Results There were no significant differences in the age,body mass index,number of antral follicles,total number of eggs,serum levels of estradiol and progesterone on the second day of the menstrual cycle and the day before endometrial transformation between the two pregnant women(P＞0.05).There were also no significant differences in the abortion rate,ectopic pregnancy rate,biochemical pregnancy rate,clinical pregnancy rate,delivery rate,and neonatal weight between the two groups(P＞0.05).In the second day of cleavage stage embryo transfer subgroup,there were no significant differences in the abortion rate,ectopic pregnancy rate,biochemical pregnancy rate,clinical pregnancy rate,delivery rate,and neonatal weight between the two groups(P＞0.05),and in the fifth day of blastocyst transfer subgroup,there were also no significant differences in abortion rate,ectopic pregnancy rate,biochemical pregnancy rate,clinical pregnancy rate,delivery rate between the two groups(P＞0.05),and in the oral dydrogesterone tablets group,the neonatal weight was significantly higher than that of the vaginal progesterone gel combined with oral dydrogesterone tablets,and the difference was statistically significant(P＜0.05).The multivariate Logistic regression analysis showed that different luteal support protocols had no significant impact on the delivery rate(OR=0.703,95％CI:0.461-1.062,P=0.09).Conclusion There were no significant differences between oral dydrogesterone tablets and vaginal progesterone gel combined with oral dydrogesterone tablets in clinical pregnancy rate and delivery rate during HRT-FET.Therefore,the use of oral dydrogesterone tablets a-lone can be a new option for luteal support in HRT-FET.