Oral Dydrogesterone Versus Vaginal Progesterone for Luteal Phase Support in Frozen–Thawed Embryo Transfer Cycles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

作者：Konstantinos Stavridis, Dimitrios Balafoutas, Theodoros Kalampokas, Vassiliki Benetou, Evangelia Samoli, Nikolaos Vlahos, Maria‐Iosifina Kasdagli · 发表于：Journal of Clinical Medicine · 年份：2025 · DOI：10.3390/jcm14093238 · 被引用次数：4 · 研究领域：Ovarian function and disorders、Reproductive Biology and Fertility、Assisted Reproductive Technology and Twin Pregnancy

Background/Objectives: Until recently, oral dydrogesterone has only been established in fresh in vitro fertilization (IVF) cycles, whereas its role in luteal phase support (LPS) for frozen embryo transfer (FET) cycles remains unclear. The aim of this study is to determine whether oral dydrogesterone as LPS in FET cycles results in pregnancy rates comparable to vaginal progesterone, focusing primarily on ongoing pregnancy rates, but also on clinical pregnancy, miscarriage, and live birth rates. Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five databases (Embase, MEDLINE®, APA PsycInfo, Global Health, and HMIC) and two additional sources were searched from inception to November 28, 2024. Only randomized controlled trials (RCTs) were included. A common effects model combined risk estimates, and heterogeneity was assessed using I2. Study quality was evaluated with Risk of Bias 2 (RoB2), and evidence certainty was graded using GRADE. Results: Overall, five RCTs with a total of 636 women were included in the meta-analysis. The comparison between oral dydrogesterone and vaginal progesterone for LPS did not yield significant differences for any of the outcomes studied. For ongoing pregnancies, the pooled odds ratio (OR) was 0.90 (95% CI: 0.59–1.35), with no heterogeneity (I2 = 8.7%). For miscarriage events, the OR was 1.41 (95% CI: 0.63–3.13, I2 = 0). For clinical pregnancies, the OR was 0.94 (95% CI: 0.62–1.42, I2 = 4...