Irmandade da Santa Casa de Misericórdia de São Paulo, School of Medical Sciences, Department of Obstetrics and Gynecology - São Paulo (SP), Brazil.
Centro de Referência da Saúde da Mulher Hospital Pérola Byington, Human Reproduction - São Paulo (SP), Brazil.
Rev Assoc Med Bras (1992). 2022 Jan;68(1):100-105. doi: 10.1590/1806-9282.20210874.
The aim of this study was to compare the use of micronized vaginal progesterone and oral dydrogesterone in the endometrial preparation for frozen-thawed embryo transfer.
This was a randomized, controlled, open, two-armed clinical trial, with women undergoing frozen-thawed embryo transfer along with hormone replacement therapy for endometrial preparation, between September 2019 and February 2021. A total of 73 patients were randomly selected and orally administered 40 mg/day dydrogesterone (dydrogesterone group, n=36) or 800 mg/day micronized vaginal progesterone (micronized vaginal progesterone group, n=37), after endometrial preparation with transdermal estradiol. The main outcome was a viable ongoing pregnancy with 12 weeks of gestation as evaluated by ultrasound.
The reproductive outcomes in frozen-thawed embryo transfer cycles were similar, with pregnancy rates in the dydrogesterone and micronized vaginal progesterone treatment groups being, respectively, 33.3 and 32.4% at 12 weeks pregnancy (confidence interval= -22.4-20.6, p=0.196).
The use of oral dydrogesterone may be a more patient-friendly approach to endometrial preparation in frozen-thawed embryo transfer cycles, avoiding undesirable side effects and discomfort resulting from vaginal administration, while also providing similar reproductive results.
本研究旨在比较米索前列醇阴道制剂和口服地屈孕酮在冻融胚胎移植中的子宫内膜准备中的应用。
这是一项随机、对照、开放、双臂临床试验,于 2019 年 9 月至 2021 年 2 月期间,对接受冻融胚胎移植并进行激素替代治疗以进行子宫内膜准备的女性进行。共有 73 名患者被随机选择,每天口服 40mg 地屈孕酮(地屈孕酮组,n=36)或 800mg 米索前列醇阴道制剂(米索前列醇阴道制剂组,n=37),经皮雌激素子宫内膜准备后。主要结局是通过超声评估的 12 周妊娠的活胎持续妊娠。
冻融胚胎移植周期的生殖结局相似,地屈孕酮和米索前列醇阴道制剂治疗组的妊娠率分别为 12 周妊娠时的 33.3%和 32.4%(置信区间= -22.4-20.6,p=0.196)。
在冻融胚胎移植周期中,口服地屈孕酮可能是一种更适合患者的子宫内膜准备方法,可避免阴道给药引起的不良副作用和不适,同时提供相似的生殖结果。