Comparison of Cumulative Live Birth Rates Between GnRH-A and PPOS in Low-Prognosis Patients According to POSEIDON Criteria: A Cohort Study

Zhang, Shaodi; Yin, Yue; Li, Qiuyuan; Zhang, Cuilian

doi:10.3389/fendo.2021.644456

Cited by 14 publications

(12 citation statements)

References 41 publications

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“…Details of the endometrial preparation and luteal support procedures used at our center have been described elsewhere ( 24 ). In brief, two methods were prepared, namely, a natural cycle for patients with regular menstrual cycles and a hormone replacement cycle for patients with irregular menstruation (or a history of thin endometrium).…”

Section: Methodsmentioning

confidence: 99%

Blastocyst quality and perinatal outcomes of frozen-thawed single blastocyst transfer cycles

et al. 2022

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ObjectiveTo investigate the effects of blastocyst quality and morphological grade on the perinatal outcomes in patients undergoing frozen-thawed single blastocyst transfer cycles.MethodsThis single-center retrospective cohort study included 2648 singleton neonates resulting from frozen-thawed single blastocyst transfers performed between January 2017 and September 2021. Multivariate logistic regression was performed to evaluate perinatal outcomes for their association with blastocyst quality and morphological parameters.ResultTransfer of a good-quality blastocyst in a frozen-thawed cycle was associated with a lower rate of preterm delivery (PTD, adjusted OR =0.7, 95% CI 0.5-0.9; P=0.020) and a higher likelihood of a male neonate (adjusted OR =1.2, 95%CI 1.0-1.5; P=0.048). Compared with grade C inner cell mass (ICM) blastocyst transfer, grade B ICM (adjusted OR =0.5, 95%CI 0.2-0.9; P=0.027) and grade A ICM (adjusted OR =0.6, 95%CI 0.3-1.5; P=0.290) blastocyst transfers were associated with a lower rate of PTD, which was more evident for grade B ICM. After adjusting for confounders, the likelihood of a male neonate (grade B TE, OR =1.2, 95%CI 1.0-1.5, P=0.037; grade A TE OR =1.9, 95%CI 1.3-28, P=0.002) increased with increasing trophectoderm (TE) quality. Compared with expansion stage 4, the likelihood of a male neonate was 1.5 times greater with transfer of a stage 6 blastocyst (OR =1.5, 95%CI 1.0-2.3; P=0.06), and the risk of small for gestational age (SGA) was greater with transfer of a stage 5 blastocyst (adjusted OR =3.5, 95%CI 1.5-8.0; P=0.004). The overall grading of the blastocyst, expansion stage, ICM grade, and TE grade were not associated with length at birth, birthweight, large for gestational age (LGA), or birth defects (all P>0.05).ConclusionsIn frozen-thawed single blastocyst transfer cycles, transfer of a good-quality blastocyst was associated with a lower rate of PTD and a greater likelihood of a male neonate. Transfer of grade B ICM blastocysts decreased the rate of PTD, and TE quality was positively correlated with the likelihood of a male neonate.

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Section: Methodsmentioning

confidence: 99%

Blastocyst quality and perinatal outcomes of frozen-thawed single blastocyst transfer cycles

et al. 2022

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“…Studies by Tang et al 1 also showed that patients with asthenospermia were more likely to use agonist regimens. However, the PPOS regimen increased the normal fertilisation rate compared with the GnRH antagonist protocol 20–22. The above results may prove that in addition to the effects of different ovarian stimulation regimens on the quality of oocytes, there is also a deviation in sperm quality in different protocols.…”

Section: Discussionmentioning

confidence: 83%

“…However, the PPOS regimen increased the normal fertilisation rate compared with the GnRH antagonist protocol. 20–22 The above results may prove that in addition to the effects of different ovarian stimulation regimens on the quality of oocytes, there is also a deviation in sperm quality in different protocols. In the present study, sperm abnormalities were a secondary cause of infertility in LFR patients and sperm motility was even a predictor of LFR.…”

Section: Discussionmentioning

confidence: 88%

Nomogram models to predict low fertilisation rate and total fertilisation failure in patients undergoing conventional IVF cycles

Wang

Wan

et al. 2022

BMJ Open

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ObjectivesTo establish visualised prediction models of low fertilisation rate (LFR) and total fertilisation failure (TFF) for patients in conventional in vitro fertilisation (IVF) cycles.DesignA retrospective cohort study.SettingData from August 2017 to August 2021 were collected from the electronic records of a large obstetrics and gynaecology hospital in Sichuan, China.ParticipantsA total of 11 598 eligible patients who underwent the first IVF cycles were included. All patients were randomly divided into the training group (n=8129) and the validation group (n=3469) in a 7:3 ratio.Primary outcome measureThe incidence of LFR and TFF.ResultsLogistic regressions showed that ovarian stimulation protocol, primary infertility and initial progressive sperm motility were the independent predictors of LFR, while serum luteinising hormone and P levels before human chorionic gonadotropin injection and number of oocytes retrieved were the critical predictors of TFF. And these indicators were incorporated into the nomogram models. According to the area under the curve values, the predictive ability for LFR and TFF were 0.640 and 0.899 in the training set and 0.661 and 0.876 in the validation set, respectively. The calibration curves also showed good concordance between the actual and predicted probabilities both in the training and validation group.ConclusionThe novel nomogram models provided effective methods for clinicians to predict LFR and TFF in traditional IVF cycles.

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“…PPOS in all POSEIDON subgroups and signi cantly higher in Group 4 with POR patients aged ≥ 35 years [12]. However, another study showed no difference in CLBR between PPOS regimen and GnRH-Ant regimen in POR population [13].…”

Section: Methodsmentioning

confidence: 91%

“…The live birth rate (LBR) was the primary outcome. The secondary outcome measures were number of oocytes retrieved, duration of gonadotropin (Gn) treatment, amount of Gn administered, fertilization rates, chemical and clinical pregnancy.PPOS in all POSEIDON subgroups and signi cantly higher in Group 4 with POR patients aged ≥ 35 years [12]. However, another study showed no difference in CLBR between PPOS regimen and GnRH-Ant regimen in POR population [13].In the present study, we retrospectively analyzed the e ciency of the PPOS, GnRH-Ant and GnRH-a protocols for patients in POSEIDON Group 3 with low AMH (< 1.2 ng/mL)/low AFC (< 5 follicles) and less than 35 years old.…”

mentioning

confidence: 89%

Comparison of Live Birth Rate Among PPOS, GnRH Antagonist and GnRH Agonist in POSEIDON Group 3

Gui

Chen

Liu

et al. 2022

Preprint

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Background It is difficult to select an ovarian stimulation protocol for the patients with poor ovarian reserve (POR) because few oocytes are retrieved in a single controlled ovarian stimulation (COS) cycle. The aim of this study was to compare the pregnancy outcomes of different protocols in POSEIDON Group 3 patients. Methods This was a retrospective cohort study. Patients met the POSEIDON Group 3 criteria who underwent assisted reproductive technology at the Reproductive center of Renmin Hospital of Wuhan University between April 2019 and August 2021 were included. The COS protocols included progestin-primed ovarian stimulation (PPOS), GnRH antagonist and GnRH agonist protocols. The live birth rate (LBR) was the primary outcome. The secondary outcome measures were number of oocytes retrieved, duration of gonadotropin (Gn) treatment, amount of Gn administered, fertilization rates, chemical and clinical pregnancy. Results A total of 309 women met the POSEIDON Group 3 criteria were included for analysis. When compared with PPOS group and GnRH antagonist group, anti-Mullerian hormone, antral follicle count and oocytes retrieved were significantly higher in GnRH agonist group (P = 0.021; P < 0.001; P < 0.001); the basal FSH value was significantly lower in GnRH agonist group (P = 0.006); the estradiol values on trigger day and growth hormone utilization rate were significantly increased in GnRH agonist group (P < 0.001; P = 0.001). However, there was no significant difference in the outcomes of embryos, without significant difference in 2 pronuclear rate, transplantable embryo rate and high-quality embryo rate among the three groups. There was also no significant difference in pregnancy outcomes, although the clinical pregnancy rate (61% vs.51.2% vs.44.9%) and LBR (33.3% vs.23.3% vs.23.2%) were higher in GnRH agonist group than PPOS and GnRH antagonist groups, but not statistically significant. The chemical pregnancy rate was significantly higher in GnRH agonist group than GnRH antagonist group (80.5% vs. 56.7%, P = 0.008). LH values on trigger day were significantly higher in GnRH antagonist group than the other two groups (P < 0.001). The cycle cancellation rate and miscarriage rate were highest in PPOS group, but without significant difference. Conclusion For patients with POR diagnosed as POSEIDON Group 3, the LBR is comparable among the PPOS, GnRH antagonist and GnRH agonist protocols. Considering the economic cost and the prevalence of COVID-19, it is recommended to use the short COS regimens with fresh embryo transplantation.

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Comparison of Cumulative Live Birth Rates Between GnRH-A and PPOS in Low-Prognosis Patients According to POSEIDON Criteria: A Cohort Study

Cited by 14 publications

References 41 publications

Blastocyst quality and perinatal outcomes of frozen-thawed single blastocyst transfer cycles

Blastocyst quality and perinatal outcomes of frozen-thawed single blastocyst transfer cycles

Nomogram models to predict low fertilisation rate and total fertilisation failure in patients undergoing conventional IVF cycles

Comparison of Live Birth Rate Among PPOS, GnRH Antagonist and GnRH Agonist in POSEIDON Group 3

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