In the world of medical practice, the problem of miscarriage remains one of the most pressing. The frequency of this pathology in the population ranges from 10 to 20%, and in the group of pregnant women after ART reaches 30%, with half of all cases occurring during the gestation period up to 12 weeks. Among the gestagen drugs approved for use during pregnancy, didrogesterone is widely known. In the CIS countries, the drug was registered with a threatening miscarriage and habitual miscarriage (against the background of an established progesterone deficiency), as well as in the treatment of infertility due to insufficiency of the luteal phase, including using methods of ART.

Currently, ART has firmly taken its place in the complex medical treatment of infertility and is becoming increasingly popular in medical practice. Support for the luteal phase in cycles, regardless of the method used, has a positive effect on the effectiveness of ART. This review is devoted to the international research program on the study of the effects of didrogesterone— LOTUS, which has become the most powerful of the registration studies on the use of gestagens in supporting the luteal phase in ART. The results of studies of the level of evidence A (Cochrane 2018) demonstrated the best efficacy of didrogesterone in relation to the incidence of pregnancy and live birth compared to vaginal micronized progesterone, which made it possible to recommend it as a new standard that can improve the outcome of pregnancy with rational use in practice.