COH+OPU 使用GnRHantagonist  vs 黃體素防止LH上升 對於囊胚之染色體影響無差異 (正常染色體囊胚比率約 42 vs 39% )

Comparison of euploidy rates of blastocysts in women treated with progestins or GnRH antagonist to prevent the luteinizing hormone surge during ovarian stimulation 

Human Reproduction, Volume 35, Issue 6, June 2020, Pages 1325–1331,

STUDY QUESTION

Does the prevalence of euploid blastocysts differ between patients treated with progestin primed ovarian stimulation (PPOS) and those treated with conventional ovarian stimulation?

SUMMARY ANSWER

The numbers of blastocysts and euploid blastocysts per patient and the number of euploid embryos per injected oocyte are similar for patients undergoing progestin-primed ovarian stimulation and for those undergoing conventional ovarian stimulation with GnRH antagonist.

WHAT IS KNOWN ALREADY

New approaches to ovarian stimulation have been developed based on the use of drugs administrable by mouth instead of via injections. Attention has been dedicated to progestins to block the LH surge. Previous data regarding the number of oocytes retrieved and the number of good-quality embryos generated in PPOS have demonstrated similar outcomes when compared to conventional ovarian stimulation, even if some concerns regarding the quality of embryos have been advanced.

STUDY DESIGN, SIZE, DURATION

This is a prospective non-inferiority age-matched case–control study. In a period of 6 months, a total of 785 blastocysts from 1867 injected oocytes obtained from 192 patients were available for analysis.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Infertile women undergoing IVF and preimplanation genetic testing (PGT) cycles were included. Forty-eight patients were treated with PPOS, and for each of them three age-matched historical controls (n = 144) treated with a GnRH antagonist protocol were selected. PGT was performed according to next-generation sequencing technology.

MAIN RESULTS AND THE ROLE OF CHANCE

Basal characteristics were similar in the two groups; a substantial similarity of the main outcome measures in the two treatment groups has also been found. The rate of formation of euploid blastocysts per oocyte was 21% in both the two treatment groups. The percentage of patients with euploid embryos and the total number of euploid blastocysts per patient (median and interquartile range, IQR) in the PPOS group were 38.7 (25.5–52.9) and 2 (1.3–3.1), respectively. These figures were not significantly different in women treated with the GnRH antagonist protocol i.e. 42 (28–53.8) and 2.1 (1.3–2.9), respectively.