Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: An RCT|
Eftekhar, Maryam; Hoseini, Masrooreh & Saeed, Lida
Background: In vitro fertilization is an important therapy for women with polycystic
ovarian syndrome (PCOS). The use of new ways of improving clinical results is yet
Objective: This study was aimed to investigate the efficacy of progesterone primed
ovarian stimulation (PPOS) and compare with conventional antagonist protocol in
Materials and Methods: A total of 120 PCOS women who were candidates for assisted
reproductive technology treatment from August to January 2019 were enrolled in this
RCT and were placed into two groups, randomly (n = 60/each). The PPOS group
received 20 mg/day Dydrogesterone orally since the second day of the cycle and the
control group received antagonist protocol. The pregnancy outcomes including the
chemical and clinical pregnancy, the miscarriage rate, and the percent of gestational
sacs/transferred embryos was compared in two groups.
Results: Number of MII oocyte, maturity rate, Number of 2 pronuclei (2PN) and serum
estradiol levels on trigger day were statistically lower in PPOS group (p = 0.019, p =
0.035, p = 0.032, p = 0.030), respectively. Serum LH level on trigger day in PPOS
group was higher than antagonist group (p = 0.005). Although there wasn’t sever
ovarian hyper simulation syndrome in any participants, mild and moderate ovarian
hyper simulation syndrome was less in PPOS group (p = 0.001). Also, the chemical
and clinical pregnancy rate were higher in the antagonist group, althoughit was not
statistically significant (p = 0.136, p = 0.093 respectively).
Conclusion: Our study demonstrate that PPOS does not improve chemical and clinical
pregnancy rate of the infertile women with PCOS.
Progesterone; Polycystic ovarian syndrome; Controlled ovarian stimulation; Frozen-thawed embryo transfer; Pregnancy rate.