A maximum of two embryos were transferred on day 3 after oocyte retrieval. Surplus embryos or blastocysts of good quality were cryopreserved utilizing the previously described fast-freezing procedure (12 (link)). Freeze-all strategy was applied in patients with elevated serum progesterone >1.5 ng/ml during COS and those with an insufficient endometrial thickness (<7 mm). The FET regimen was performed in natural or modified natural cycles for ovulatory women and standard hormone replacement cycles for anovulatory women. For all patients undergoing embryo transfer, LPS will continue until 10-12 weeks of gestation, with an intramuscular progesterone injection of 40mg per day, plus dydrogesterone tablet (Duphaston, Abbott, Hoofddorp, Netherlands) 30mg per day or vaginal progesterone (8% Crinone, Merck Serono, Switzerland) 90mg per day. The LPS will be discontinued if the serum pregnancy test is negative or the transvaginal ultrasound reveals pregnancy failure.
Duphaston
Manufactured by Abbott
Sourced in United States, Netherlands
Duphaston is a pharmaceutical product manufactured by Abbott. It is a synthetic progestogen used as a hormonal supplement.
Automatically generated - may contain errors
Lab products found in correlation
Crinone, by Merck Group (11 mentions)
Progynova, by Bayer (8 mentions)
Crinone 8, by Merck Group (3 mentions)
Femoston, by Abbott (3 mentions)
Crinone gel, by Merck Group (1 mentions)
Estradiol, by Bayer (1 mentions)
Progesterone sustained release vaginal gel, by Merck Group (1 mentions)
Cyproterone acetate, by Bayer (1 mentions)
46 protocols using duphaston
1
Embryo Cryopreservation and FET Protocol
2
Thawed Embryo Transfer Protocols
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Survival of thawed cleavage embryos was evaluated morphologically immediately after thawing. Embryos with more than half of their cells intact were judged as survived and could be transferred. Three main types of protocols were used to prepare the endometrium, as reported previously (10 (link)): the natural cycle, hormone replacement cycle, or human menopausal gonadotropin-stimulated cycle. The preparation type was determined by the patient’s menstrual cycle pattern. Daily intramuscular injection of 60 mg of progesterone plus 20 mg oral progesterone (Duphaston, Abbott, Nertherlands) was started 3 days before day-3-embryo transfer or 5 days before blastocyst transfer, for luteal-phase support. Serum β-hCG was measured 12 days after embryo transfer, and a value >50 IU/ml was considered as a positive pregnancy. Daily intramuscular injections of progesterone were reduced to 40 mg combined with 20 mg oral progesterone, and continued until the 10th week of pregnancy.
3
Luteal Support for Blastocyst Transfer
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Routine luteal support was performed from the day of egg retrieval, with 30mg oral dydrogesterone tablets (Duphaston, Abbott Biologicals B. V., H20170221) and progesterone sustained-release vaginal gel (Fleet Laboratories Limited, H20140552) 90mg placed vaginally. On day 5 after egg retrieval, high-scoring blastocysts were selected for embryo transfer according to embryo status and the patient’s specific condition.
Peripheral blood was collected from the patient 14 days after embryo transfer to measure the β-hCG levels. Transvaginal ultrasound was performed to evaluate embryo implantation after day 28–35 of fresh single blastocyst transfer (SBT), and the presence of a pregnancy sac was identified as a clinical pregnancy. If clinical pregnancy was confirmed, luteal support was continued until approximately 12 weeks gestation. If embryo loss or loss of fetal heartbeat occurred, it was marked as an abortion.
Peripheral blood was collected from the patient 14 days after embryo transfer to measure the β-hCG levels. Transvaginal ultrasound was performed to evaluate embryo implantation after day 28–35 of fresh single blastocyst transfer (SBT), and the presence of a pregnancy sac was identified as a clinical pregnancy. If clinical pregnancy was confirmed, luteal support was continued until approximately 12 weeks gestation. If embryo loss or loss of fetal heartbeat occurred, it was marked as an abortion.
4
Endometrial Preparation for Frozen Embryo Transfer
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The transfer of thawed embryos was carried out when the endometrial thickness reached 8 mm after a step-up regimen for endometrial preparation. Estradiol valerate (Progynova®, Bayer) was administered orally at 6–8 mg/day on day 2 of the menstrual cycle, which was followed by vaginal administration of micronized progesterone (Uterogestan, Besins International, France) 400 mg BID or combined administration of oral dydrogesterone (Duphaston®; Abbott Biologicals, Netherlands) 10 mg BID and progesterone/oil injection (Progesterone Injection 20 mg/ml, Zhejiang Xianju Pharmaceutical Co., Ltd., China) 40–60 mg QD.
5
Intrauterine Insemination Protocol for Infertility
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After 3 to 7 days of abstinence and 2 hours prior to insemination, semen samples were collected at the laboratory and then kept liquefaction at 37°C for 30 minutes. The semen was washed with 2-layer density gradient centrifugation and followed by a count and motility evaluation (14 (link), 15 (link)). Before the start of IUI procedure, patient and partner identification were confirmed. Each operation to gently place a dose of prepared sperm (0.5mL) into the lower uterine segment of a patient was completed by one of the center’s gynecologists in an artificial insemination room with a soft catheter (Cook Group, USA). At the end of the procedure, patients were advised to lay supine for half an hour. Luteal support was routinely offered to all patients with oral dydrogesterone (Duphaston, Abbott Biologicals, USA) 10 mg twice daily from the day after IUI for 14 days.
6
Estradiol Valerate and Aspirin in IVF Embryo Transfer
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The subjects took oral estradiol valerate (Progynova, Delpharm Lille; Leverkusen, German) on the second or third day of the menstrual cycle at a dose of 4–8 mg, lasting for 10–14 days to promote endometrial proliferation. The dosage and duration of estradiol were raised until the endometrial thickness reached a proper state for embryo transfer (commonly at least 0.7 cm), at which time vaginal progestin (200 mg once daily, Utrogestan, Besins Healthcare; Chatswood, NSW, Australia) and oral dydrogesterone (20 mg twice daily, Duphaston, Abbott; Chicago, IL, USA) were added. The patients in the aspirin group received aspirin 50 mg per day orally after the last menses. Physicians would consider the patients’ maternity history, gynecological ultrasound, and sex hormone levels to decide whether to give aspirin treatment. If conception was confirmed, the subjects had exogenous estrogen for 7 weeks and exogenous progesterone for 10 weeks. In the Aspirin group, aspirin would be withdrawn after the embryocardia beats showed up in 7 weeks. We defined this usage of aspirin as short-term usage.
7
Modified Natural Cycle for Frozen Embryo Transfer
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For all patients, a modified NC was used for endometrium preparation. A modified NC involves administration of HCG to trigger ovulation. The method for embryo and endometrium synchronization for FET was as follows. Follicular growth was monitored by measuring the levels of serum hormones and performing ultrasound from cycle day 10. When the diameter of the dominant follicle was >16 mm and the endometrial thickness was >8 mm, with estrogen >150 pg/mL and progesterone <1.0 ng/mL, one of two procedures was performed, depending upon the patient’s luteinizing hormone (LH) value. If LH was <20 IU/L, 5000 IU of HCG was administered at night (21:00) to trigger ovulation, and the transfer of 3-day-old embryos was performed 5 days later. The quality of the transferred embryos was monitored and was good (grade I and II 8-cell blastomere embryos), as this is vital for a successful outcome. If the LH value was >20 IU/L, 5000 IU HCG was injected the same afternoon, and the embryo transfer was conducted 4 days later. Beginning on the third day after HCG injection, 40 mg of dydrogesterone (Duphaston™, Abbott Laboratories, Abbott Park, IL, USA) was given every day for luteal support. Embryo transfer was performed with ultrasound monitoring. When pregnancy was achieved, the progesterone supplement was continued until 8 weeks of gestation [9 (link)].
8
Euploid Blastocyst Transfer Protocol
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All embryos were cryopreserved and embryo transfer was performed after the second menstruation following oocyte retrieval. Based on the menstrual cycle of the patients, the endometrium was prepared through a natural ovulatory cycle or an artificial regimen. The luteal phase was supported with oral dydrogesterone twice daily (20 mg; Duphaston, Abbott, USA) and vaginal progesterone capsules once daily (200 mg; Utrogestan, Besins Manufacturing, Belgium). Single euploid blastocyst transfer was performed as recommended.
9
Controlled Ovarian Stimulation Protocol
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COS was started on 2~4 days of menstrual cycle. Medroxyprogesterone Acetate (MPA) (10 mg/day, Zhejiang Xianju Pharmaceutical Co., China) or Duphaston (20 mg/d; Abbott Biologicals B.V., Netherlands) was administrated with gonadotrophin from the initial of COS and continued up to the trigger day. As soon as at least three follicles reached the diameter of ≥18mm, the maturation of follicles was triggered by Decapeptyl (0.1 mg; Ferring Pharmaceuticals Ltd., Saint-Prex, Switzerland) and human chorionic gonadotropin (hCG) (1000 IU; Lizhu Pharmaceutical Trading Co., China) (17 (link)). Oocyte aspiration was performed 35.5~36.5 hours after trigger.
10
Hormone Therapy Regimen for Frozen Embryo Transfer
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Patients in the control group received HT regime for FET. Oral estradiol valerate (Progynova, Delpharm Lille) at a dose of 4–8 mg/day was initiated on day 2 or 3 of the menstrual cycle and commonly lasted for 10–14 days to promote endometrial proliferation. The dosage and duration of estrogen were increased until the endometrial thickness reached an appropriate state for embryo transfer (commonly, at least 8 mm), at which time vaginal progestin (200 mg/day Utrogestan, Besins Healthcare) and oral dydrogesterone (20 mg b.i.d Duphaston, Abbott) were added. Patients who received FET earlier than 2011 were treated with intramuscular injection of progesterone (Progesterone Injection, Zhejiang Xianju Pharmaceutical Co., Ltd) instead.
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