According to a community-based cross-sectional study on the prevalence of primary infertility and its associated risk factors in urban population of Central India by A Katole, a quarter of women who suffer from infertility in the world, between 15 to 20 million, reside in India.
Quoting the research published in the Journal of Obstetrics and Gynecology of India, Dr Nandita Palshetkar, president of FOGSI (Federation of Obstetrics and Gynecological Society of India) observed that 10-15 per cent of clinically recognised pregnancies worldwide end in a miscarriage and Indian women have a higher prevalence of miscarriage—as high as 32 per cent.
Addressing the media on Thursday afternoon, Dr Palshetkar said, "Given rapid urbanization and the shift in cultural dynamics, maternal age in India is advancing. Moreover, an increase in the number of miscarriages can lead to an increase in the likelihood of subsequent miscarriages to 13-17 per cent after the first miscarriage and 55 per cent after the third miscarriage. This underscores the need for medicines and treatments that ensure healthy pregnancies."
Accordingly, she suggested Oral Dydrogesterone as one of the solutions to the problem, saying that "it helps improve pregnancy outcomes as it is a potent treatment for prevention of miscarriage during the first trimester and for luteal phase support during in-vitro fertilization (IVF)."
Her opinion was seconded by Sieneke Bult-Muntinga, site director, Abbott Netherlands, the company that is manufacturing Dydrogesterone in Netherlands, and Dr Ameet Patki, medical director of Fertility Associates, a centre for Assisted reproduction in Mumbai. Dydrogesterone has been in use for various pregnancy related complications since years, but it is its potential use in the treatment of infertility that makes it much talked-about now. The manufacturing process of Dydrogesterone involves the conversion of progesterone, a natural hormone present in the body involved in the successful maintenance of pregnancy.
"To have a healthy pregnancy a woman needs to have sufficient levels of progesterone because its deficiency can result in implantation failure and early miscarriages. Dydrogesterone is a progesterone which can increase the chances of a successful pregnancy in women who have a history of recurrent abortions," said Dr. Patki.
Dydrogesterone is easily absorbed by the body and is more effective orally, explained Bult-Muntinga. This means dydrogesterone can be effective at a dose that is 10-20 times lower. It is taken orally as a tablet which is more convenient than a vaginal cream or intramuscular injection.
According to the research funded by Abbott and published in the Human Reproduction journal, oral dydrogesterone had similar efficacy and tolerability to micronized vaginal progesterone (MVP), which is the current standard of care globally to prepare the uterus lining for pregnancy.
While Abbott manufactures Dydrogesterone at its facility in Netherlands, it is not the only company to do so. Last year in December, Mankind Pharma, an Indian firm launched the generic Dydrogesterone tablets in India for the treatment of infertility and pregnancy-related complications.
