Posttransfer support for the transfer of one cryopreserved embryo at the blastocyst stage

• Sergey V. Nikitin
• Mariya P. Grishchuk
• Lubov G. Dokaeva
• Svetlana S. Paskar
• Irina S. Chernen’kaya

Abstract

Background. The article presents the results of a comparative analysis of protocols for preparing the endometrium for the transfer of thawed embryos against the background of hormone replacement therapy.

Aim of the study – to compare the effectiveness and safety of oral dydrogesterone compared with vaginal micronized progesterone in post-transfer support cycles during the transfer of a single cryopreserved embryo at the blastocyst stage.

Material and methods. A retrospective comparative study included 259 patients aged 25 to 45 years who underwent the transfer of one own thawed embryo in a cycle of hormone replacement therapy for the period from January to December 2022 in the Department of Reproductology of the Mother and Child Clinic, St. Petersburg. The patients were divided into 2 groups for complete secretory transformation of the endometrium: group 1 (n=145) used dydrogesterone at a dose of 30 mg/day, group 2 (n=114) – micronized vaginal progesterone (MVP) at a dose of 600 mg/day. The primary endpoint was the rate of clinical pregnancy, the secondary endpoint was the rate of ongoing pregnancy at 12 weeks. In cases of ongoing and ongoing pregnancy, support with gestagens continued up to 20 weeks.

Results. Efficiency rates in the group using dydrogesterone were significantly higher, but the data did not reach statistical significance. The clinical frequency in group 1 (dydrogesterone) amounted to 53.8% (78/145), in group 2 (MVP) – 43.9% (50/114) however, p>0.05. The frequency of ongoing pregnancy at 12 weeks of gestation is group 1 was 51.7% (75/145) versus 41.2% (50/114), p>0.05.

Conclusion. The results of the study showed that dydrogesterone is a suitable option for supporting LF in cycles with the transfer of thawed embryos and can help achieve higher rates of clinical and ongoing pregnancy compared to vaginal micronized progesterone. Dydrogesterone can be recommended as a drug of choice in supporting the post-transfer period in cycles with the transfer of a thawed embryo.

Keywords: cryopreserved embryo; post-transfer support cycle; hormone replacement therapy; dydrogesterone

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