Comparison of the ongoing pregnancy rate of first frozen-thawed embryo
transfer cycles in women undergoing IVF using progestin primed ovarian
stimulation versus GnRH antagonist protocol
Abstract
Objective To compare the pregnancy outcomes of first frozen-thawed
embryo transfer in women undergoing IVF using progestin primed ovarian
stimulation (PPOS) versus GnRH antagonist protocol. Design Retrospective
cohort study. Setting Tertiary-care academic medical center.
Population/Sample 382 infertile women with normal ovarian reserve
underwent IVF. Methods Women were allocated to PPOS group (n=184) or
GnRH antagonist group (n=198) at the discretion of the attending
physicians. Main outcome measures The primary outcome was the ongoing
pregnancy rate of first FET cycles. Results Both groups had almost
comparable demographic and cycle stimulation characteristics. The
ongoing pregnancy (34.0 % (49/114) vs 42.3% (52/123), P=0.166,
RR=0.81(0.59-1.09)), clinical pregnancy (38.2% (55/144) vs 44.7%
(55/123), P=0.281, RR=0.85 (0.64-1.14)) and implantation (29.5%
(75/254) vs 31.6% (68/215), P=0.623, RR=0.93 (0.71-1.22)) rates were
comparable between the PPOS group and the antagonist group respectively.
In order to control the difference in demographic and index stimulated
IVF cycle characteristics, a multivariate logistic regression revealed
that only the stimulation protocol and number of embryos replaced were
significant factors in predicting the ongoing pregnancy. Conclusion The
use of medroxyprogesterone during ovarian stimulation is effective in
blocking the LH surge, and does not affect the number of oocytes
collected in the woman with normal ovarian reserve.
However,developmental potential of embryos originating from this
regimen seems to be affected compared to those from the antagonist
group.