Impact of Pretreatment with Dydrogesterone versus Estradiol Valerate Combined with Dydrogesterone on ICSI success in women with Polycystic Ovary Syndrome: A Comparative Study | ||||
| Sohag Medical Journal | ||||
| Volume 29, Issue 3, 2025, Page 27-35 PDF (954.32 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/smj.2025.395321.1582 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Ahmed Salah Ali   1; mohamed yahya abdel hafez2; Mostafa Atya1; Hazem Abd El Ghafar3; MOHAMED SABRY4
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| 1obstetrics and genecology department faculty of medicine- sohag university - sohag - Egypt | ||||
| 2obesterics and gynacology faculty of medicine sohag university | ||||
| 3obesterics and gynacology faculty of medicine sohag university | ||||
| 4Obstetriacs and Gynaecology department, faculty of medicine. Sohag University, Egypt | ||||
| Abstract | ||||
| Background: For women facing infertility because of PCOS who haven’t conceived through timed intercourse or IUI, ART like ICSI offer a path forward. Various ovarian stimulation methods are employed in ICSI, including protocols using GnRH agonists, GnRH antagonists, and POPS . Administering steroids in the cycle before ICSI synchronizes follicle development and schedule the treatment start for women with PCOS. This research investigates how pretreatment with dydrogesterone alone compares to a combination of estradiol valerate and dydrogesterone in terms of embryological outcomes and pregnancy rates following ICSI in females with PCOS. Results: We noticed no statistically significant differences between the group pretreated with dydrogesterone only and the group receiving combined estradiol valerate and dydrogesterone. Conception rates were similar (49.05% vs. 59.15%, P=0.4), as were clinical pregnancy rates (41.5% vs. 51.05%, P=0.4) and implantation rates (27.12% vs. 32.71%, P=0.65). While the combined estrogen-progesterone pretreatment showed a improved ICSI outcomes in PCOS patients, the pregnancy rate difference compared to dydrogesterone-only pretreatment wasn’t statistically significant. No OHSS happened in both groups. Conclusions: Pretreatment before ICSI, using either dydrogesterone alone or a combination of estradiol valerate and dydrogesterone, helps schedule cycles, synchronize follicle growth, yield a high number of mature oocytes, enhance conception, implantation, and clinical pregnancy rates, and prevent OHSS in females with PCOS. Compared to dydrogesterone alone, the combined pretreatment protocol reduced the required gonadotrophin dosage, thereby lessening the cost for patients, and yielding more oocytes. The combined approach improved ICSI outcomes in PCOS patients while reducing the rate of multiple pregnancies. | ||||
| Keywords | ||||
| PCOS; Dydrogesterone; Estradiol valerate; POPS; GnRH antagonist | ||||
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