The objective of this systematic review was to assesses whether the orally acting
progestagen,
dydrogesterone lowers the incidence of subsequent
miscarriage in women with
recurrent miscarriage. A computerized search was performed in Medline, Embase and Ovid Medline for original reports with the product name "
Duphaston" or "
dydrogesterone" and limited to clinical human data. Thirteen reports of
dydrogesterone treatment were identified. Two randomized trials and one non-randomized comparative trial were identified, including 509 women who fulfilled the criteria for meta-analysis. The number of subsequent
miscarriages or continuing pregnancies per woman was compared in women receiving
dydrogesterone compared to standard
bed rest or placebo intervention. There was a 10.5% (29/275)
miscarriage rate after
dydrogesterone administration compared to 23.5% in control women (odds ratio for
miscarriage 0.29 [confidence interval 0.13-0.65] and 13% absolute reduction in the
miscarriage rate). The adverse and side effects were summarised in all 13 reports, and seemed to be minimal. Although all the predictive and confounding factors could not be controlled for, the results of this systematic review show a significant reduction of 29% in the odds for
miscarriage when
dydrogesterone is compared to standard care indicating a real treatment effect.