• J Formos Med Assoc · Apr 2024

    Non-inferiority of progestin-primed ovarian stimulation versus GnRH antagonist protocol: A propensity score-weighted analysis.

    • Le Duc Thang, Bao LongHoangHInstitute of Gastroenterology and Hepatology, Hanoi, Viet Nam., Do Thi Thu Trang, Phan Ngoc Quy, Giap Thi Mai Phuong, Bui Thi Hanh, Than Trong Thach, Nguyen Thi Lien Huong, Le Hoang, and Jean-Noël Hugues.
    • Tam Anh General Hospital, Hanoi, Viet Nam. Electronic address: thangld@tamanhhospital.vn.
    • J Formos Med Assoc. 2024 Apr 1; 123 (4): 523529523-529.

    PurposeTo evaluate the effectiveness of the progestin-primed ovarian stimulation (PPOS) protocol versus the gonadotropin-releasing hormone antagonist (GnRH-ant) protocol in ovarian stimulation.MethodsIn this retrospective cohort study, we included 804 patients who were treated between January 1st, 2022, and July 1st, 2023. Outcomes of ovarian stimulation were compared between the PPOS (n = 206) and GnRH-ant (n = 598). The primary outcome was the number of good cleavage embryos.ResultsBaseline characteristics were comparable in both groups. In both unadjusted and adjusted analysis, the mean number of good cleavage embryos in PPOS (6.33) was non-inferior to GnRH-ant (6.44; unadjusted ratio of two means 1.02, 95%CI 0.92, 1.13). The trigger-day estradiol level in patients with PPOS was higher than in patients with GnRH-ant (4,420 vs 3,830 pg/ml, respectively) despite similar total follicle stimulating hormone dose and fewer days of ovarian stimulation. The number of oocytes, MII oocytes, cleavage and blastocyst embryos were comparable between the two protocols. After the first transfer of embryos, the clinical pregnancy rate and implantation rate were higher in the PPOS group, while the pregnancy rate and ongoing pregnancy were not significantly different. None of the PPOS patients had an unexpected LH surge, and serum LH levels decreased slightly during ovarian stimulation.ConclusionsThe PPOS protocol with dydrogesterone provided similar embryo outcomes to the GnRH-ant protocol, with notable distinctions in clinical pregnancy and implantation rate. The serum LH concentration during ovarian stimulation using PPOS was well-controlled.Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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