Gonadotropin-releasing hormone antagonist versus progestin for the prevention of premature luteinising hormone surges in poor responders undergoing in vitro fertilisation treatment: study protocol for a randomised controlled trial

Wang, Yun; Kuang, Yanping; Chen, Qiuju; Cai, Renfei

doi:10.1186/s13063-018-2850-x

Cited by 28 publications

(24 citation statements)

References 20 publications

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“…Informed consents were obtained from each patient before any study procedure was performed, in accordance with good clinical practice. The study design, methods, inclusion and exclusion criteria have been described in detail elsewhere (23).…”

Section: Methodsmentioning

confidence: 99%

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Progestin vs. Gonadotropin-Releasing Hormone Antagonist for the Prevention of Premature Luteinizing Hormone Surges in Poor Responders Undergoing in vitro Fertilization Treatment: A Randomized Controlled Trial

et al. 2019

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Objective: Progestin was recently used as an alternative of gonadotropin-releasing hormone (GnRH) analog for preventing premature luteinizing hormone (LH) surge with the aid of vitrification techniques, however, limited data were available about the potential of progestin in poor responders undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. We performed a randomized parallel controlled trial to investigate the difference of progestin and GnRH antagonist in poor responders.Methods: A total of 340 poor responders who met with Bologna criteria were randomly allocated into the progestin-primed ovarian stimulation (PPOS) group and GnRH antagonist group. Fresh embryo transfer was preferred in the GnRH antagonist group and freeze-all was performed in the PPOS group. The primary outcome was the incidence of premature LH surge, secondary outcomes were the number of retrieved oocytes, the number of viable embryos and the pregnancy outcomes.Results: The results showed that the incidence of premature LH surge in PPOS group was lower than that in antagonist group (0 vs. 5.88%, P < 0.05). In PPOS group, the average numbers of oocytes and viable embryos were comparable to those in GnRH antagonist group (3.7 ± 2.6 vs. 3.4 ± 2.4; 1.6 ± 1.7 vs. 1.4 ± 1.3, P > 0.05), the live birth rate was similar between the two groups (21.8 vs. 18.2%, RR 1.25 (95% confidence interval 0.73, 2.13), P > 0.05).Conclusions: The study demonstrated that PPOS had a more robust control for preventing premature LH rise than GnRH antagonist in poor responders, but PPOS in combination with freeze-all did not significantly increase the probability of pregnancy than GnRH antagonist protocol for poor responders.

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Section: Methodsmentioning

confidence: 99%

“…The primary outcome endpoint was the incidence of premature LH surge, defined as the serum LH >15 mIU/ml on the trigger day, with or without dominant follicle rupture and increased serum progesterone (23). Premature ovulation was defined as the dominant follicle rupture before the scheduled time.…”

Section: Treatmentmentioning

confidence: 99%

Progestin vs. Gonadotropin-Releasing Hormone Antagonist for the Prevention of Premature Luteinizing Hormone Surges in Poor Responders Undergoing in vitro Fertilization Treatment: A Randomized Controlled Trial

et al. 2019

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“…The controlled ovarian hyperstimulation (COH) regimen was previously described ( Wang et al, 2016 , 2018 ). All aspirated oocytes were transferred to modified human tubal fluid (HTF) medium (Irvine Scientific, United States) and then transferred to culture medium.…”

Section: Methodsmentioning

confidence: 99%

The Valuable Reference of Live Birth Rate in the Single Vitrified-Warmed BB/BC/CB Blastocyst Transfer: The Cleavage-Stage Embryo Quality and Embryo Development Speed

et al. 2020

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Background: It is unclear whether we should focus attention on cleavage-stage embryo quality and embryo development speed when transferring single particular grade vitrified-warmed blastocysts, especially poor-quality blastocysts (grade "C"). Method: This retrospective study considered 3386 single vitrified-warmed blastocyst transfer cycles from January 2010 to December 2017. They were divided into group 1 (AA/AB/BA, n = 374), group 2 (BB, n = 1789), group 3 (BC, n = 901), and group 4 (CB, n = 322). The effects of cleavage-stage embryo quality and embryo development speed were measured in terms of clinical pregnancy and live birth rates in each group. Results: Pregnancy outcomes showed a worsening trend from groups 1 to 4; the proportion of embryos with better cleavage-stage quality and faster development speed decreased. In group 1, only the blastocyst expansion degree 3 was a negative factor in the clinical pregnancy rate (odds ratio (OR) [95% confidence interval (CI)]: 0.233 [0.091-0.595]) and live birth rate (0.280 [0.093-0.884]). In the other groups (BB, BC, and CB), blastocysts frozen on day 5 had significantly better clinical pregnancy outcomes than those frozen on day 6: 1.373 [1.095-1.722] for group 2, 1.523 [1.055-2.197] for group 3, and 3.627 [1.715-7.671] for group 4. The live birth rate was 1.342 [1.060-1.700] for group 2, 1.544 [1.058-2.253] in group 3, and 3.202 [1.509-6.795] in group 4, all Ps < 0.05). The degree of blastocoel expansion three for clinical pregnancy rate in group 2 (0.350 [0.135-0.906], P < 0.05) and day 3 blastomere number (>7) for live birth rate in group 4 (2.455 [1.190-5.063], P < 0.05) were two important factors. Conclusion: We should consider choosing BB/BC/CB grade blastocysts frozen on day 5, CB grade blastocysts with day 3 blastomere numbers (>7), and AA/AB/BA grade blastocysts with degrees of expansion (≥4) to obtain better pregnancy outcomes.

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“…A randomized controlled trial is being conduced to investigate the potential of progestin(medroxyprogesterone) for poor responders undergoing IVF. 9 Further controlled trials should be performed to endorse the use of this new treatment regimen and to ascertain the ideal dose and day of initial administration; nevertheless, the results suggest an easier and safer potential strategy to prevent the LH rise in IVF/cryopreservation cycles.…”

Section: /3 Assisted Reproductionmentioning

confidence: 99%

Desogestrel for preventing a premature luteinizing hormone (LH) surge in a cycle for oocyte cryopreservation

Bessow¹,

Donato²,

Filho³

2018

Hum. Reprod. Arch.

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Objectives:The advance of cryopreservation techniques turn possible the use of new strategies for LH supression during in vitro fertilization (IVF) cycles. Methods: The use of progesterone instead of gonadotropin-releasing hormone (GnRH) analogues seems to be a feasible option. Desogestrel is a progesterone broadly known and accepted in the context of contraception, with a good tolerability and low cost, in addition to a potent anti-ovulatory potency. Results: The present case is the first describing a succesfully controlled ovarian hyperstimulation (COH) for social oocyte cryopreservation using desogestrel 75mcg as a LH blocker in a healthy 35-year-old woman. Conclusions: the use of progesterone for LH supression seems to be a great option in the context of oocyte cryopreservation, since it is safe, less expensive and patient-friendly, avoiding the daily injections of GnRH analogues.

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Gonadotropin-releasing hormone antagonist versus progestin for the prevention of premature luteinising hormone surges in poor responders undergoing in vitro fertilisation treatment: study protocol for a randomised controlled trial

Cited by 28 publications

References 20 publications

Progestin vs. Gonadotropin-Releasing Hormone Antagonist for the Prevention of Premature Luteinizing Hormone Surges in Poor Responders Undergoing in vitro Fertilization Treatment: A Randomized Controlled Trial

Progestin vs. Gonadotropin-Releasing Hormone Antagonist for the Prevention of Premature Luteinizing Hormone Surges in Poor Responders Undergoing in vitro Fertilization Treatment: A Randomized Controlled Trial

The Valuable Reference of Live Birth Rate in the Single Vitrified-Warmed BB/BC/CB Blastocyst Transfer: The Cleavage-Stage Embryo Quality and Embryo Development Speed

Desogestrel for preventing a premature luteinizing hormone (LH) surge in a cycle for oocyte cryopreservation

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