Vaginal progesterone versus oral dydrogesterone for luteal phase support in intrauterine insemination cycles: A prospective cohort study

INTRODUCTION: To compare vaginal progesterone and oral dydrogesterone for luteal phase support in intrauterine insemination (IUI) cycles.
METHODS: This study was conducted with patients who applied to the Infertility Clinic of the Department of Obstetrics and Gynecology at İstanbul Medeniyet University Prof. Dr. Süleyman Yalçın City Hospital between June 2021 and December 2021. In this prospective cohort study, 109 IUI cycles of 49 patients were examined. Vaginal progesterone (Progestan® 200 mg Soft Capsule, Koçak Farma) 1×200 mg was given to 54 cycles in the control group, and oral dydrogesterone (Duphaston® 10 mg Film Tablet, Abbott) 2×10 mg was given to 55 cycles in the study group.
RESULTS: Eleven (20.4%) pregnancy test results in the vaginal progesterone group and six (11.1%) pregnancy test results in the dydrogesterone group were found to be positive. There was no significant difference between vaginal progesterone and dydrogesterone groups in terms of end-of-cycle pregnancy positivity, including the subgroup analyses for treatment type and infertility etiology (p>0.05). As a result of univariate analyses, it was determined that follicle-stimulating hormone (FSH) was negatively correlated with end-of-cycle pregnancy positivity (OR: 0.547; 95%CI: 0.328–0.913; p=0.021). One unit increase in FSH level reduces pregnancy positivity by 54%. According to the results of multivariate analysis, one unit increase in FSH level reduces pregnancy positivity by 56%, but it is not statistically significant (OR: 0.565; 95%CI: 0.315–1.012; p=0.055).
DISCUSSION AND CONCLUSION: Although there were higher pregnancy rates in patients who used vaginal micronized progesterone for luteal phase support in IUI cycles, compared to patients who used oral dydrogesterone, no statistically significant difference was found between the two groups.