JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):244
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263837

P-232. The Role of Progesterone in Fertility Treatment: A Real-World Perspective

Mariana Gianisella Ribeiro¹, Layaly Ayoub Silva¹, Ermeni Pires Nascimento¹, Enzo Eid Nakano¹, Isabela Shiozawa Nolasco¹, Julia Roverso Correa Silveira¹, Gabriel Monteiro Pinheiro¹

¹ Universidade Santo Amaro - São Paulo – SP -Brasil

Objective: This review aims to explore how progesterone works in luteal phase support (LPS) during fertility treatments. We wanted to understand not only how effective and safe it is, but also how patients actually experience these treatments in practice. While clinical trials lay the groundwork, our focus includes insights from real-world use—especially with the growing use of oral formulations like dydrogesterone.
Methods: We carried out a narrative literature review by searching PubMed and Google Scholar. We included studies published between 2015 and 2025, in English and Portuguese. Search terms included "luteal phase support," "progesterone," "dydrogesterone," "routes of administration," and "IVF." The goal was to gather data comparing different administration routes, treatment durations, and reported outcomes—both from controlled trials and post-marketing studies.
Results: Progesterone is essential for reproduction. It helps prepare the uterus for embryo implantation and supports early pregnancy—especially after ovarian stimulation during IVF. Without proper luteal support, success rates in fertility treatments can decrease significantly. Traditionally, vaginal micronized progesterone has been widely used. However, in recent years, oral dydrogesterone has become increasingly common. Studies have shown that it offers similar or sometimes even better outcomes in terms of pregnancy and live birth rates. One of its main advantages is how easy it is to take—oral tablets are often preferred by patients compared to vaginal or injectable alternatives. Tolerability is a big plus as well. Taking a pill is generally more acceptable for most people, especially when considering factors like personal comfort or cultural preferences. This often leads to better adherence and overall satisfaction with the treatment. In terms of safety, dydrogesterone has a long track record. It has been used by over 147 million women, contributing to more than 20 million successful pregnancies. So far, studies and pharmacovigilance data haven't found any consistent evidence linking it to major risks. No biological mechanism has been proven to suggest that dydrogesterone might cause harm, and available data has reinforced its reputation as a safe and reliable option.
Conclusion: Supplementing with progesterone is a key part of successful fertility treatments. Among the options, oral dydrogesterone stands out for being both effective and more user-friendly. It combines clinical success with better patient comfort and strong safety data. As the field of reproductive medicine moves toward more personalized and humane care, dydrogesterone represents an option that supports not just outcomes—but also the overall experience of those going through fertility treatment.