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.

Autor:	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
Předmět:	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
Zdroj:	BJOG: An International Journal of Obstetrics & Gynaecology; Jun2017, Vol. 124 Issue 7, p1048-1055, 8p, 1 Diagram, 3 Charts
Abstrakt:	Objective: 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.Design: A randomised parallel controlled trial.Setting: Tertiary-care academic medical centre.Participants: A cohort of 300 infertile women undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) treatment.Methods: 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.Main Outcome Measures: 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.Results: 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.Conclusions: 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.Tweetable Abstract: An RCT confirmed similar pregnancy outcome in P-primed ovarian stimulation with a daily dose of 4 or 10 mg MPA. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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