Oral Dydrogesterone Versus Micronized Vaginal Progesterone for Luteal Phase Support Following Invitro Fertilization (IVF): A Prospective Multicenter Randomized Controlled Study in Enugu, South-Eastern Nigeria
1 Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology/Teaching Hospital, Enugu, Nigeria
2 Department of Pharmacology and Therapeutics, College of Medicine, State University of Medical and Applied Sciences, Igbo-Eno/0020Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria.
3 Department of Pharmacology and Therapeutics, College of Medicine, Chukwuemeka Odumegwu Ojukwu University, Anambra State, Nigeria.
* Corresponding Author
ORCID Details
Nweze Sylvester Onuegbunam: https://orcid.org/0000-0002-4768-1072
Ezenwaeze Malachy Nwaeze: https://orcid.org/0000-0002-9318-8764
Chukwu Clinton Leo: https://orcid.org/0009-0002-9408-0744
Research Article
World Journal of Advanced Pharmaceutical and Medical Research, 2026, 11(02), 001–017.
Article DOI: 10.53346/wjapmr.2026.11.2.0018
Publication history:
Received on 30 August 2026; revised on 05 October 2026; accepted on 07 October 2026
Abstract:
Background: Infertility is a major reproductive health problem, and in vitro fertilization (IVF) is an important treatment option. Adequate luteal phase support (LPS) is essential following IVF because controlled ovarian stimulation may impair endogenous luteal function. Micronized vaginal progesterone (MVP) is widely used, but its vaginal route may be inconvenient and associated with local adverse effects. Oral dydrogesterone (OD) offers a potentially more convenient alternative. However, comparative evidence remains inconsistent, particularly in African populations.
Objective: To compare the efficacy, safety and tolerability of oral dydrogesterone with micronized vaginal progesterone for LPS among women undergoing IVF in selected fertility centres in Enugu, South-Eastern Nigeria.
Methods: This prospective, multicentre, single-blind randomized controlled study involved 112 women undergoing IVF, randomized equally into two groups. Group A received oral dydrogesterone 30 mg daily with vaginal placebo, while Group B received MVP 100 mg twice daily with oral placebo, commencing on the day of oocyte retrieval. Embryo transfer occurred between Days 2 and 5. Pregnancy outcomes, uterine contractions, vaginal bleeding, miscarriage, additional intervention and treatment-emergent adverse effects were assessed. Data were analysed using Student's t-test, chi-square or Fisher's exact test, with significance set at p ≤ 0.05.
Results: Baseline characteristics were comparable. Positive pregnancy tests occurred in 33.9% of the dydrogesterone group versus 37.5% of the MVP group, while clinical pregnancy rates were 30.4% and 33.9%, respectively. Pregnancy continuation to 14 weeks occurred in 25.0% and 28.6%, respectively. These differences were not statistically significant. Miscarriage rates were also not significantly different (8.9% vs. 3.6%; p = 0.219). However, uterine contractions (66.1% vs. 39.2%; p = 0.004), vaginal bleeding (64.3% vs. 23.2%; p < 0.001) and additional intervention (66.1% vs. 30.4%; p < 0.001) were significantly more frequent with dydrogesterone.
Conclusion: OD and MVP produced comparable pregnancy and miscarriage outcomes. However, MVP was associated with fewer symptomatic events and less need for additional intervention. Larger randomized trials are recommended to further evaluate their comparative efficacy, safety, tolerability and cost-effectiveness.
Keywords:
Infertility; In Vitro Fertilization; Luteal Phase Support; Oral Dydrogesterone; Micronized Vaginal Progesterone; Pregnancy Outcome; Miscarriage; Nigeria.
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