Estradiol 2mg / Dydrogesterone 20mg tablets

Dydrogesterone (DYG) in the progestin-primed ovarian stimulation (PPOS) protocol is an alternative progestin with weaker pituitary suppression than medroxyprogesterone acetate (MPA) in women with normal ovulation. However, the endocrinological characteristics, oocyte retrieval, and pregnancy outcomes of DYG in PPOS patients undergoing in vitro fertilization (IVF) remain unclear. This systematic review aimed to compare the efficacy of DYG and MPA in PPOS protocols in IVF/intracytoplasmic sperm injection (ICSI) cycles. Studies published between 2018 and 2024 were identified through PubMed and the Cochrane Library. After screening and applying the eligibility criteria, only full-text articles directly comparing DYG and MPA in PPOS protocols for IVF/ICSI were included. A total of three studies involving 1,172 patients were analyzed. Both DYG and MPA effectively suppressed premature luteinizing hormone (LH) surges, with no significant differences in the oocyte yield, fertilization rates, or clinical pregnancy rates. DYG was associated with slightly higher post-trigger follicle-stimulating hormone (FSH) levels and lower LH levels compared to MPA, while both groups showed similar estradiol and progesterone trends. Some studies reported significantly lower gonadotropin requirements in the DYG group. Pregnancy outcomes, including biochemical and clinical pregnancy rates, implantation, and miscarriage, were comparable between groups. These findings indicate that both DYG and MPA are effective and safe for LH surge suppression in PPOS protocols, with DYG potentially offering a more physiologic hormonal profile and reduced gonadotropin use. Further randomized controlled trials are recommended to validate these results.

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IntroductionPremature ovarian insufficiency (POI) is characterized by impaired ovarian endocrine function and reduced ovarian reserve.MethodsWe searched eight bibliographic databases, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and the Chinese Clinical Trial Registry (ChiCTR) from inception to May 30, 2026, for parallel-group randomized controlled trials comparing HRT-based regimens with pure oral Chinese herbal formulas within three prespecified therapeutic-principle categories. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251234457).ResultsMenstrual return or resumption was designated as the patient-important outcome, while follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH) were designated as primary surrogate biomarkers. Forty-one HRT-controlled trials met the prespecified therapeutic-principle criteria. No clear between-group difference was detected for menstrual return or resumption (4 studies, 266 participants; odds ratio [OR] 1.523, 95% confidence interval [CI] 0.315 to 7.371; I2 = 86.16%). Point estimates favored oral herbal formulas for FSH (37 studies; mean difference [MD] -5.563, 95% CI -8.230 to -2.896; I2 = 99.13%) and AMH (12 studies; MD 0.167, 95% CI 0.035 to 0.299; I2 = 98.17%), but both were surrogate outcomes and their prediction intervals crossed the null. Directionally favorable estimates were also observed for luteinizing hormone (LH), estradiol (E2), antral follicle count (AFC), and peak systolic velocity (PSV), although these were surrogate or exploratory outcomes with substantial uncertainty. Fewer adverse events were reported with oral herbal formulas, but safety remained unestablished because ascertainment and reporting were incomplete. Therapeutic-principle analyses yielded an exploratory subgroup signal only for FSH and did not establish comparative superiority among kidney-tonifying alone (PK), kidney-tonifying and liver-soothing (KL), and kidney-tonifying and blood-activating (KB) categories. All assessed outcomes were rated as very low-certainty evidence.DiscussionCurrent evidence does not support the routine use of any specific Chinese herbal formula or therapeutic-principle category. Guideline-based management, including HRT when clinically appropriate, should remain standard care, and rigorously designed multicenter trials using patient-important outcomes and standardized safety reporting are needed.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251234457.

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BackgroundA normal luteal function is an essential factor for maintaining pregnancy; luteal phase deficiency decreases embryo implantation and pregnancy rate and increases the early miscarriage rate. In stimulated in vitro fertilization-embryo transfer (IVF-ET) patients, luteal phase support (LPS) is achieved by the exogenous supplementation with progesterone to increase endometrial receptivity and pregnancy. While several protocols exist, no commonly accepted protocol has been established for optimal luteal support after IVF-ET to date, the purpose of this study was to investigate the effect of two different luteal phase support protocols in patients undergoing assisted reproductive technologies.MethodsIn a prospective open, randomized study conducted in a private IVF Unit a total of 700 infertile patients, undergoing in vitro fertilization treatment, were recruited for this study. All patients had a mild ovarian stimulation protocol with GnRH antagonist. The patients were randomized into two groups based on the type of luteal phase support route: Group A, control group (n = 310) patients received our routine LPS protocol which consists of the administration of 800 mg of micronized vaginal progesterone and Group B, study group, (n = 310) patients received a combination of oral dydrogesterone 20 mg and 90 mg of a gel of vaginal micronized progesterone Pregnancy rate, live birth rate, implantation rate and miscarriage rate were evaluated as primary endpoints. Statistical analysis was performed using JMP software (version 17; SAS, Inc., Cary, NC, USA). A P ≤ 0.05 was considered statistically significant.ResultsNo differences were observed between the two groups in terms of pregnancy rate (Group A 34,9% vs. Group B 35,7%), live birth rate (Group A 30,6% vs. Group B 29,2%), miscarriage rate (Group A 12% vs. Group B 18%) and implantation rate (Group A 18,6% vs. Group B 17,1%).ConclusionsThe combination of two different formulations of progesterone (vaginal and oral) for luteal phase support does not improve IVF outcomes when compared to the vaginal route of progesterone administration alone.Trial registrationThe study has been retrospectively registered with the Clinical Trials registry reference number ISRCTN52148405 ( http://isrctn.org/ ).

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ObjectiveThis study aimed to evaluate the clinical efficacy of Jia Wei Shoutai Wan (JWSTW) combined with dydrogesterone in patients with threatened abortion (TA) complicated by endometrial cavity fluid (ECF).MethodsThis was a prospective, single-center, randomized controlled trial. A total of 130 patients with TA and ECF admitted to our hospital from January to November 2022 were screened. Thirteen patients did not meet the inclusion criteria, and five refused to participate, leaving 112 eligible participants. Using a random number table, patients were assigned to a control group (dydrogesterone alone, n = 56) or a combination group (dydrogesterone plus JWSTW, n = 56). Both groups received continuous treatment for 14 days. During follow-up, 3 patients withdrew and 6 were excluded, resulting in 103 cases included in the final analysis (control group, n = 50; combination group, n = 53). The primary outcomes were ECF area and Traditional Chinese Medicine (TCM) syndrome scores (vaginal bleeding, lower abdominal pain, fatigue and tiredness, knee soreness, and lumbago) after 14 days of treatment. Secondary outcomes included serum levels of progesterone (P), β-human chorionic gonadotropin (β-HCG), and estradiol (E2); coagulation indices [D-dimer (D-D), fibrinogen (FIB), and prothrombin time (PT)]; clinical efficacy; and adverse reactions.ResultsAfter treatment, the combination group showed significantly lower TCM symptom scores and a smaller ECF area (p p p = 0.360). The overall clinical efficacy of the combination group was superior to that of the control group (p ConclusionJWSTW combined with dydrogesterone may be beneficial for treating TA with ECF by improving clinical symptoms, optimizing hormone and coagulation profiles, and reducing ECF without increasing adverse reactions.

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