Effectiveness of the flexible progestin primed ovarian stimulation protocol compared to the flexible GnRH antagonist protocol in women with decreased ovarian reserve

Türkgeldi, Engin; Yıldız, Şule; Cekic, Sebile Guler; Shakerian, Bahar; Keleş, İpek; Ata, Barış

doi:10.1080/14647273.2020.1794060

Cited by 25 publications

(19 citation statements)

References 24 publications

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“…Chen et al proved that compared with the antagonist regimen, PPOS regimen could better prevent the appearance of premature LH surge for poor responders [16]. But we found similar conclusion in a study [17] that also targeted DOR patients. There was also no difference in the incidence of premature LH surge between the exible PPOS group and antagonist group.…”

Section: Discussionsupporting

confidence: 82%

Comparison of Progestin-Primed Ovarian Stimulation Regimen and Antagonist Regimen in Diminished Ovarian Reserve Patients Over 35 Years of Age

Wang

Jiang

et al. 2021

Preprint

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Background the aim of this study was to compare the efficacy of progestin-primed ovarian stimulation (PPOS) regimen and GnRH antagonist regimen in infertile patients older than 35 years with diminished ovarian reserve (DOR). Methods a retrospective cross-sectional study of 196 in vitro fertilization (IVF) cycles between January 2016 and January 2020 was performed. The measured outcomes included the number of retrieved oocytes, incidence of premature LH surge, laboratory indicators and frozen embryo transfer (FET) outcome. Results the number of oocytes retrieved in the antagonist group was higher than those in the PPOS group (p < 0.05). Incidence of premature LH surge in two groups showed no difference (p > 0.05). E2 and P on HCG administration day of antagonist group were higher than those of PPOS group (p < 0.05). And there was no significant difference between two groups of FET outcome indicators (p > 0.05). Conclusions for DOR patients over 35 years of age, antagonist regimen would retrieve more oocytes than PPOS regimen. Therefore, from the perspective of oocyte retrieving, the antagonist regimen might be more suitable for DOR patients over 35 years old.

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Section: Discussionsupporting

confidence: 82%

Comparison of Progestin-Primed Ovarian Stimulation Regimen and Antagonist Regimen in Diminished Ovarian Reserve Patients Over 35 Years of Age

Wang

Jiang

et al. 2021

Preprint

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“…To our knowledge, regarding the comparison of PPOS protocols and GnRH antagonist protocols, there are 11 studies, including four RCTs (20,22,26,27), two prospective studies (28,29) and five retrospective cohort studies (19,21,(30)(31)(32). The populations in these studies had different characteristics, including PCOS, POR, normal ovarian response and donor oocyte cycles.…”

Section: Comparisons With Other Reportsmentioning

confidence: 99%

Comparison of the Cumulative Live Birth Rates of Progestin-Primed Ovarian Stimulation and Flexible GnRH Antagonist Protocols in Patients With Low Prognosis

Zhang

et al. 2021

Front. Endocrinol.

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ObjectiveTo compare the cumulative live birth rate (CLBR) of the progestin-primed ovarian stimulation (PPOS) protocol with that of the flexible GnRH antagonist protocol in patients with poor prognosis diagnosed per the POSEIDON criteria.MethodsThis was a retrospective cohort study. Low-prognosis women who underwent IVF/ICSI at the Reproductive Center of Third Affiliated Hospital of Zhengzhou University between January 2016 and January 2019 were included according to the POSEIDON criteria. The CLBR was the primary outcome of interest. The secondary outcome measures were the numbers of oocytes retrieved, 2PN embryos, available embryos and time to live birth.ResultsA total of 1329 women met the POSEIDON criteria for analysis. For POSEIDON group 1, the dosage of gonadotropin (Gn) was higher in the PPOS group than in the GnRH antagonist group (2757.3 ± 863.1 vs 2419.2 ± 853.1, P=0.01). The CLBR of the PPOS protocols was 54.4%, which was similar to the rate of 53.8% in the GnRH antagonist group. For POSEIDON group 2, the number of available embryos was higher in the PPOS group (2.0 ± 1.7 vs 1.6 ± 1.4, P=0.02) than in the GnRH antagonist group. However, the CLBRs of the two groups were similar (18.1% vs 24.3%, P=0.09). For POSEIDON groups 3 and 4, there were no statistically significant differences in the number of oocytes retrieved, 2PN, available embryos or CLBR between the two protocols. After adjustments for confounding factors, the CLBR remained consistent with the unadjusted rates. In the POSEIDON group 1 population, the GnRH antagonist protocols had a shorter time to live birth (P=0.04).ConclusionFor low-prognosis patients diagnosed per the POSEIDON criteria, the CLBR of PPOS protocols is comparable to that of GnRH antagonist protocols. In the POSEIDON group 1 population, the GnRH antagonist protocols resulted in a shorter time to live birth.

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“…Engin Turkgeldi and co-workers' research validated the novel fPPOS protocol as a flexible GnRH antagonist strategy to prevent DOR patients from premature ovulation and produces an equal proportion of metaphase-two ovocytes [21].…”

Section: Discussionmentioning

confidence: 99%

Fixed Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: RCT

Tahoun¹,

Elgazzar

Shedid

et al. 2021

Benha Journal of Applied Sciences

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Background: In vitro fertilization for women with polycystic ovarian syndrome is an essential (PCOS). New methods to improve clinical outcomes are still needed. Objective: this research investigated the effectiveness of PPOS and compared it with the standard PCOS antagonist regimen. Materials and procedures: A total of 76 PCOS women eligible for aided therapy of reproductive technology were recruited in this RCT from February 2020 to May 2021 and put in random two groups (n=38/per group). Since the sixth day of the cycle, the PPOS group has received 20 mg/day orally of Dydrogesterone, while the control group received antagonist treatment. In addition to safety, our results were chemical and clinical pregnancy. Results: oocyte retrieval counts, oocyte metaphase II (MII) and MI have been comparable. There are also comparable numbers of fertilized oocytes and cleaved embryos without any statistical difference in the number of injected oocytes. Lower antagonistic gonadotropin dosage than the PPOS group (2957.8±301.9 vs 3197.4±545.9), with higher stimulation times respectively in the PPOS group than the antagonist. Similar findings across both main outcome groups (OHSS) with no instances of FPPOS and just one case (2.6 percent) of moderate OHSS antagonists. Similar findings also for secondary results (biochemical pregnancy rate , clinical pregnancy rate and miscarriage rate). Conclusion: the established In PCOS patients receiving IVF/ICSI therapy, PPOS is a safe and successful procedure.

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Effectiveness of the flexible progestin primed ovarian stimulation protocol compared to the flexible GnRH antagonist protocol in women with decreased ovarian reserve

Cited by 25 publications

References 24 publications

Comparison of Progestin-Primed Ovarian Stimulation Regimen and Antagonist Regimen in Diminished Ovarian Reserve Patients Over 35 Years of Age

Comparison of Progestin-Primed Ovarian Stimulation Regimen and Antagonist Regimen in Diminished Ovarian Reserve Patients Over 35 Years of Age

Comparison of the Cumulative Live Birth Rates of Progestin-Primed Ovarian Stimulation and Flexible GnRH Antagonist Protocols in Patients With Low Prognosis

Fixed Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: RCT

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