Luteal Phase Support using Oral Dydrogesterone-a Prospective Treatment for Future Replacing Micronized Vaginal Progesterone
Journal Title: Open Access Journal of Reproductive System and Sexual Disorders - Year 2018, Vol 1, Issue 4
Abstract
Although micronized vaginal progesterone is the accepted norm for use in luteal phase support (LPS) in controlled ovarian stimulation (COS) that is used for in vitro fertilization (IVF) cycles, recently importance of oral Dydrogesterone has got the importance in lieu of its oral availability, cheap, no cumbersome side effects and no definitive newer fetal side effects. After the LOTUS 1 trial with a multicenter double placebo, double dummy design it has proved an equal efficacy if not superiority of oral D, over micronized vaginal progesterone and it seems D might soon become the standard of care for LPS in conventional IVF cycles besides its routine indication for recurrent abortions. A potent orally active progesterone receptor agonist D was developed in the1950’s. Structurally it is 6-dehyro-9β,10α-progest (figure 1). It has been used for multiple disorders like premenstrual syndrome [1], cycle irregularity [2], endometriosis [3], habitual abortion [4], along with for post-menopausal hormone therapy [5], since its advent. Advantages of D and its active metabolite, 20hydroxy D, is that unlike other progesterone (P) member family, they do not have any relevant clinically, agonistic or antagonistic activity on either androgen, estrogen and glucocorticoid receptors and have only mild mineralocorticoid properties [6-8]. Main advantage from other synthetic P’s is lack of androgenic side effects like hirsutism, voice changes, acne etc. and no masculinizing changes in the fetus. Because of safety concerns in view of cross-receptor activation has prevented use of a majority of progestins during fertility therapy and pregnancy.
Authors and Affiliations
Kulvinder Kochar Kaur, Gautam Allahbadia, Mandeep Singh
Keywords
Related Articles
- EP ID EP638866
- DOI 10.32474/OAJRSD.2018.01.000119
- Views 96
- Downloads 0
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