ISSN 1518 0557
Progestin-Primed Ovarian Stimulation is a non-inferior alternative to the GnRH Antagonist Protocol in patients undergoing assisted reproductive techniques: a retrospective study

2022; 26
João Pedro Junqueira Caetano, Luciana Campomizzi Calazans, Leci Veiga Caetano Amorim, Leonardo Matheus Ribeiro Pereira, Erica Becker de Sousa Xavier, Ana Luisa Menezes Campos, Bruna Barbosa Coimbra, Ricardo Mello Marinho
JBRA Assist. Reprod. 2022; 26 (1):38-43

Received November 11, 2020
Accepted May 29, 2021
Abstract

OBJECTIVE: Demonstrate the non-inferiority of Clinical Pregnancy Rates in Progestin Primed Ovarian Stimulation compared to GnRH Antagonist Protocol when the freeze-all and blastocyst transfer strategy is applied. METHODS: A retrospective study included all IVF cycles performed at Pró-Criar Reproductive Medicine Center, Belo Horizonte, Minas Gerais, Brazil, between May 2018 and May 2019 using a GnRH antagonist analogue or oral progestins to block the LH peak in IVF/intra-cytoplasmic sperm injection (ICSI) cycles for infertility treatment. RESULTS: The primary outcome of our study was Clinical Pregnancy Rate at the first ET (Blastocyst), was 58.4% in the progestin group and 54.9% in the antagonist group (P = 0.735), a finding consistent with most studies published to date using different progestins. The mean number of retrieved oocytes was 11 in the antagonist group and 9 oocytes in the progestin group (P = 0.009). The fertilization rate was 80% for both groups (P= 0.935). The rate of blastocyst formation per cycle was 50% in the antagonist group and 55.6% in the progestin group (P = 0.106). Stimulation lasted a mean of 10 days in the two analysed groups (P = 0.403) and did not vary with patient age in either group. The gonadotropin dose used was higher in the antagonist group (2025 IU) than in the progestin group (1950 IU) (P = 0.057). In addition, the blockade was effective: there was only one case of spontaneous ovulation, which corresponded to less than 1% of the cycles.CONCLUSIONS: PPos is a non-inferiority alternative to the GnRH Antagonist Protocol in patients undergoing ART. An incidence compatible with the 0.34 to 8% risk described in the literature for failure to control the premature LH surge in antagonist protocol cycles.


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doi: 10.5935/1518-0557.20210057

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