• Ting-Chi Huang, Yu-Hung Lin, Song-Po Pan, Yi-An Tu, Chu-Chun Huang, Mei-Jou Chen, Jiann-Loung Hwang, and Shee-Uan Chen.
• Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
• J Formos Med Assoc. 2020 Nov 1; 119 (11): 1642-1649.

Background/PurposeTo investigate whether switching GnRH antagonist (GnRHant) to medroxyprogesterone acetate (MPA) sequentially in the middle of controlled ovarian stimulation could effectively prevent premature LH surge in a GnRHant protocol in patients turn out to be at a high risk of ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation.MethodsThis is a retrospective cohort study.ResultsPremature LH surge did not occur in both groups of patients. The switch protocol group had a significantly fewer days of GnRHant treatment (3.1 ± 1.0 vs. 6.5 ± 1.2) compared with GnRHant protocol group. The mean duration of MPA treatment was 3.6 ± 1.1 days. There were no statistically significant differences in terms of live birth, implantation, and clinical pregnancy rates.ConclusionThis study showed that MPA could sequentially replace GnRHant and effectively prevent premature LH surge after several days of GnRHant administration in patients being at high risk of OHSS during controlled ovarian stimulation. Switch protocol could individualize freeze-all policy and reduce the injection burden of GnRHant.Copyright © 2020. Published by Elsevier B.V.

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