We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
New trial of progestin-primed ovarian stimulation using dydrogesterone versus a typical GnRH antagonist regimen in assisted reproductive technology.
- Authors
Iwami, Nanako; Kawamata, Miho; Ozawa, Naoko; Yamamoto, Takahiro; Watanabe, Eri; Moriwaka, Osamu; Kamiya, Hirobumi
- Abstract
<bold>Purpose: </bold>To compare the clinical and ongoing pregnancy rates between a protocol using oral dydrogesterone with human menopausal gonadotropin (HMG) for progestin-primed ovarian stimulation (PPOS) and the typical gonadotropin-releasing hormone (GnRH) antagonist regimen in women undergoing controlled ovarian hyperstimulation (COH).<bold>Methods: </bold>This was a prospective, controlled study of 251 women who underwent COH for in vitro fertilization between October 2016 and July 2017. The patients were allocated alternately into two groups: a dydrogesterone protocol (study group) and a GnRH antagonist protocol (control group). In study group, dydrogesterone (20 mg/day) plus HMG (150 or 225 IU) were administered simultaneously beginning on days 2 or 3 of the menstrual cycle. In both groups, all high-quality embryos were cryopreserved for later transfer. The primary outcome was the ongoing pregnancy rate at 12 weeks per frozen-thawed embryo transfer (FET) and the secondary outcome was the clinical pregnancy rate.<bold>Results: </bold>None of the patients experienced a premature luteinizing hormone surge. During the follow-up period, 397 FET cycles were completed. The ongoing pregnancy rates at 12 weeks were 40.0% in study group versus 38.1% in control group (absolute difference 1.9%; 95% CI - 6.83 to 17.2%). The clinical pregnancy rate in study group (52.8%) was also not inferior to that in control group (49.5%; absolute difference 3.3%; 95% CI - 4.02 to 20.2%).<bold>Conclusions: </bold>The clinical and ongoing pregnancy rates in study group were comparable to those in control group. Therefore, PPOS with dydrogesterone is a reasonable option to provide COH.
- Subjects
LUTEINIZING hormone releasing hormone antagonists; BIRTH rate; COMPARATIVE studies; CRYOPRESERVATION of organs, tissues, etc.; EMBRYO transfer; FERTILIZATION in vitro; GONADOTROPIN; HORMONE antagonists; LONGITUDINAL method; LUTEINIZING hormone; RESEARCH methodology; MEDICAL cooperation; INDUCED ovulation; PROGESTATIONAL hormones; RESEARCH; STEROIDS; EVALUATION research; RANDOMIZED controlled trials
- Publication
Archives of Gynecology & Obstetrics, 2018, Vol 298, Issue 2, pN.PAG
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-018-4856-8