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- Title
The pregnancy outcome of progestin-primed ovarian stimulation using 4 versus 10 mg of medroxyprogesterone acetate per day in infertile women undergoing in vitro fertilisation: a randomised controlled trial.
- Authors
Dong, J; Wang, Y; Chai, WR; Hong, QQ; Wang, NL; Sun, LH; Long, H; Wang, L; Tian, H; Lyu, QF; Lu, XF; Chen, QJ; Kuang, YP; Chai, W R; Hong, Q Q; Wang, N L; Sun, L H; Lyu, Q F; Lu, X F; Chen, Q J
- Abstract
<bold>Objective: </bold>To investigate the clinical outcome and endocrinological characteristics of progestin-primed ovarian stimulation (PPOS) using 4 versus 10 mg of medroxyprogesterone acetate (MPA) per day in infertile women with normal ovary reserve.<bold>Design: </bold>A randomised parallel controlled trial.<bold>Setting: </bold>Tertiary-care academic medical centre.<bold>Participants: </bold>A cohort of 300 infertile women undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) treatment.<bold>Methods: </bold>Human menopausal gonadotropin (hMG; 225 iu per day) and MPA (group A, 10 mg per day; group B, 4 mg per day) were started simultaneously from cycle day 3 onwards. Ovulation was co-triggered by human chorionic gonadotropin (hCG; 1000 iu) and gonadotropin-releasing hormone agonist (GnRH agonist; 0.1 mg) when dominant follicles matured. Viable embryos were cryopreserved for later frozen embryo transfer (FET) in both groups.<bold>Main Outcome Measures: </bold>The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the incidence of a premature surge in luteinising hormone (LH), the number of viable embryos, and clinical pregnancy outcomes.<bold>Results: </bold>The number of oocytes retrieved and viable embryos were similar between two groups (9.8 ± 6.3 versus 9.6 ± 5.9; 4.2 ± 2.6 versus 3.7 ± 3.0; P > 0.05). No significant difference was found in clinical pregnancy rate (58.0 versus 48.7%) and live birth rate per participant (48.7 versus 42.0%; P > 0.05). No premature LH surge and ovarian hyperstimulation syndrome (OHSS) occurred in either group.<bold>Conclusions: </bold>Progestin-primed ovarian stimulation (PPOS) using 4 or 10 mg of MPA per day was comparable in terms of the number of oocytes retrieved and pregnancy outcome after FET. The administration of 4 mg of MPA per day was sufficient to prevent an untimely LH rise in women undergoing IVF/ICSI treatment.<bold>Tweetable Abstract: </bold>An RCT confirmed similar pregnancy outcome in P-primed ovarian stimulation with a daily dose of 4 or 10 mg MPA.
- Subjects
HUMAN in vitro fertilization; PREGNANCY; PROGESTATIONAL hormones; OVARIES; MEDROXYPROGESTERONE; FEMALE infertility; RANDOMIZED controlled trials; THERAPEUTICS; INFERTILITY treatment; CHORIONIC gonadotropins; COMPARATIVE studies; EMBRYO transfer; FERTILIZATION in vitro; HUMAN reproductive technology; LUTEINIZING hormone; RESEARCH methodology; EVALUATION of medical care; MEDICAL cooperation; INDUCED ovulation; RESEARCH; STATISTICAL sampling; EVALUATION research; TREATMENT effectiveness
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2017, Vol 124, Issue 7, p1048
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.14622