Comparison of thecumulative live birth rates
after one ART cycle
including all subsequent frozen–thaw cycles in women undergoing IVF
using progestin primed ovarian stimulation versus long GnRH agonist
protocol
Hong Chena, Zhi
Qin Chena#,
Ernest
Hung Yu Ngb, Zheng Wanga,
Di
Yaoa, Jia Ping Pana, Jun Jie Qu, Kun
Ming Li, Xiao Ming
Tenga#
aCentre of Assisted
Reproduction,
Shanghai First Maternity and Infant
Hospital, Tongji University School of Medicine, China.
bDepartment of
Obstetrics &Gynaecology, The University of Hong Kong, Hong Kong Special
Administrative Region, China.
Correspondence address. Center of Assisted Reproduction, Shanghai First
Maternity and Infant Hospital, Tongji University School of Medicine, No
536. Changle Road, 200051, Shanghai, China. Tel:(86)21-54035206;
Contact: Zhi Qin Chen, Xiao Ming Teng;
Email:ptchen1@hotmail.com,
tengxiaoming@51mch.com.
ABSTRACT
Background
There is scarcity of information about the cumulative live birth
rates(CLBRs) and time to live birth(TTLB) between progestin primed
ovarian stimulation protocol(PPOS) and long GnRH agonist protocol.
Objective
To compare CLBRs and TTLB in women with normal ovarian reserve following
PPOS with long GnRH agonist protocol.
Methods
A total of 995 women who underwent IVF using either PPOS (n=509)
or GnRH antagonist (n=486) ovarian
stimulation at the discretion of the attending physicians. The primary
outcome measure was the CLBRs within 18 months from the day of ovarian
stimulation.
Results
Both groups had almost comparable demographic and cycle stimulation
characteristics except for duration of infertility which was shorter in
the PPOS group. CLBRs after one complete IVF cycle including fresh and
subsequent FET cycles within 18 months follow up were significantly
lower in the PPOS group compared that in the long agonist group 206/509
(40.5%) and 307/486 (63.2%), respectively (odds ratio (OR): 0.641;
95% CI: 0.565-0.726). The average TTLB was significantly shorter in the
long agonist group compared to the PPOS group (P < 0.01). In
Kaplan-Meier analysis, the cumulative incidence of ongoing pregnancy
leading to LB was significantly higher in the long agonist compared in
the PPOS group (P < 0.001). Cox regression analysis revealed
stimulation protocol adopted was strongly associated with the CLBRs
after adjusting other confounding factors (OR =1.917 (1.152-3.190),
P=0.012).
Conclusion
PPOS offers no advantage over conventional protocol in women with a
normal ovarian reserve undergoing IVF.
Keywords: PPOS, long GnRH agonist protocol, IVF, CLBRs, TTLB