Effects of two different types of luteal support on pregnancy outcomes following antagonist fresh embryo transfer

Abstract Background : There are few reports on the use of progesterone vaginal gel in combination with dydrogesterone in the antagonist protocol for fresh embryo transfer. This study compared the effects of differing luteal support on the pregnancy outcomes following the antagonist protocol for fresh embryo transfer. Methods : A retrospective analysis of clinical data from infertile patients who underwent fresh embryo transfer via the antagonist protocol (2785 cycles) from February to July 2019 and from February to July 2021 at the Peking University Third Hospital Reproductive Medicine Centre was performed. The groups were divided according to their luteal support into a progesterone vaginal gel group (single medication group; 1170 cycles) and progesterone vaginal gel plus dydrogesterone group (combination medication; 1615 cycles). After propensity score matching, the clinical pregnancy, ongoing pregnancy, early miscarriage, and ectopic pregnancy rates were compared between the two groups. Results : A total of 1057 pairs of cycles were successfully propensity score matched. The clinical and ongoing pregnancy rates in the combination medication group were significantly higher than those in the single medication group (P < 0.05), whereas the differences in early miscarriage and ectopic pregnancy rates between the two groups were not significant (both P > 0.05). Conclusions : Combined luteal support after the antagonist protocol is preferred for patients undergoing fresh cycle embryo transfer.