Progesterone-primed ovarian stimulation versus gonadotropin-releasing hormone antagonist in women with polycystic ovarian syndrome

Abstract

Abstract Background The researchers aimed in this study to compare the impact of progesterone-primed ovarian stimulation (PPOS) in comparison to the gonadotrophin-releasing hormone (GnRH) antagonist protocol in patients with PCOS as regards the number of oocytes aspirated, percentage of MII oocytes, and the good-quality blastocysts rate which are valid for cryopreservation. Methods 100 female patients with polycystic ovarian syndrome (PCOS) were retrieved. They were then subsequently randomized into two separate groups of equal size: Group A (50 cases) received GnRH-antagonist SC injection from the 6th day of ovarian stimulation and was continued till the GnRH agonist trigger day. However, group B (50 cases) received a daily dose of 20 mg dydrogesterone from day 1 or 2 of menstruation and was continued till the GnRH agonist trigger day. We compared both protocols regarding the quantity of oocytes aspirated, the percentage of MII oocytes, and the good-quality blastocysts rate which are valid for cryopreservation. Also, we compared the fertilization rate, blastocyst rate, and clinical pregnancy rate after the first FET. Results The mean number of retrieved oocytes and the percentage of MII oocytes in group A were 33.22 oocytes and 78.06% respectively, while in group B was 36.85 oocytes and 77.62% respectively showing no statistically significant difference between the two groups, as the p -value was more than 0.05. The rate of good-quality blastocysts was 28.72% in group A and 29.14% in group B, indicating there was no significant difference, with a p -value of 0.44. Conclusion When it comes to the number of recovered oocytes, the percentage of MII oocytes, the rate of high-quality blastocysts available, and finally, the clinical pregnancy rate following the first FET, the recent PPOS protocol was just as successful as the GnRH-antagonist protocol for the controlled ovarian stimulation in PCOS patients.