使用progestin(PPOS, duphaston 20mg/d) vs  GnRH antagonist 應用於試管誘導排卵之LH抑制 

PPOS 組和 GnRH antagonist的整倍體率相當（分別為 12.5% 和 16.0%，P > 0.05）。

兩組FET在每次移植的妊娠試驗陽性率、臨床懷孕率、流產率、子宮外孕率或活產率方面均無顯著差異。

Comparison of the euploidy rate  following progestin-primed vs GnRHantagonist protocol

• Euploidy rate was comparable between the PPOS and antagonist group (12.5% vs. 16.0% respectively, P > 0.05). 
• No significant differences were observed between the two groups in positive pregnancy test, clinical pregnancy, miscarriage, ectopic pregnancy, or live birth rates per transfer in the first frozen embryo transfer cycles.
• Both PPOS and antagonist protocols had similar euploidy rates in PGT-A cycles.

Variables	PPOS group (n = 120)	Antagonist group (n = 120)	P-value
Starting dose of FSH (IU)	225.0 (225.0-225.0)	225.0 (225.0-225.0)	0.134
Total dosage of FSH (IU)	1800.0 (1575.0-2025.0)	1800.0 (1575.0-2212.5)	0.010
Duration of stimulation (days)	8.0 (7.0-8.8)	8.0 (7.0–9.0)	0.053
Serum estradiol level on trigger day (pg/ml)	1870.5 (912.7-2940.1)	1061.3 (592.0-2614.1)	0.007
Serum LH level on trigger day (IU/l)	4.3 (2.7–5.9)	2.4 (1.6–3.6)	0.000
Serum progesterone level on trigger day (ng/ml)	0.9 (0.6–1.2)	0.8 (0.6–1.2)	0.588
Premature ovulation (%)	0.8 (1/120)	0.8 (1/120)	1
No. of retrieved oocytes (n)	6.0 (3.0–10.0)	5.0 (3.0–10.0)	0.914
No. of mature occytes (n)	4.5 (2.0–8.0)	4.0 (3.0–9.0)	0.980
No. of oocytes fertilized (n)	3.0 (2.0–7.0)	3.0 (2.0–6.0)	0.728
Fertilization rate (%)	94.4 (75.0-100)	92.9 (75.0-100)	0.746
Cleavage rate (%)	100 (100–100)	100 (100–100)	0.648
No. of blastocysts formation (n)	1.5 (0–3.0)	1.0 (0–3.0)	0.422
Blastocysts formation rate (%)	59.4 (33.3–100)	50.0 (33.3–80)	0.299
Total No. of euploid blastocysts	93	97
No. of euploid blastocysts (n)	0 (0–1.0)	0 (0–1.0)	0.995
Euploid blastocysts rate per injected oocyte (%)	12.5 (0–25.0)	16.0 (0-27.7)	0.477
Euploid blastocysts rate per woman (%)	33.3 (0-66.7)	50.0 (0-66.7)	0.459
No. of cycles with no blastocyst for biopsy (%)	27.5 (33/120)	30.0 (36/120)	0.669
No. of cycles with no euploid blastocysts for transfer (%)	52.5 (63/120)	55.0 (66/120)	0.698

PPOS group (n = 53)	Antagonist group (n = 47)	P-value
Endometrial preparation, n (%)			0.995
Natural cycles	1.9 (1/53)	2.0% (1/47)
Clomid-induced	11.5 (6/53)	10.0 (5/47)
Hormonal cycles	83.0 (44/53)	91.5 (43/47)
Endometrial thickness (day of trigger) (mm)	10.0 (8.6–11.0)	9.1 (8.5–10.4)	0.600
hCG test positive rate (%)	66.0 (35/53)	70.2 (33/47)	0.655
Clinical pregnancy rate (%)	58.5 (31/53)	59.6 (28/47)	0.912
Clinical miscarriage rate (%)	9.7 (3/31)	17.9 (5/28)	0.359
Ectopic pregnancy rate (%)	0 (0/35)	0 (0/33)	0
Live birth rate (%)	52.8 (28/53)	48.9 (23/47)	0.359

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使用progestin(PPOS, duphaston 20mg/d) vs  GnRH agonist vs GnRH antagonist 應用於試管誘導排卵之LH抑制 

本研究評估了黃體素促排卵方案 (PPOS)、促性腺激素釋放激素（GnRH）激動劑方案和促性腺激素釋放激素（GnRH）拮抗劑方案植入前非整倍體基因檢測 (PGT-A) 週期的整倍體率及懷孕結果。

整倍體囊胚率/MII卵母細胞比率 在三組間相當(14.60% vs. 14.09% vs. 13.94%) 

在生化妊娠、臨床妊娠、持續妊娠、著床率、流產率、異位妊娠率以及首次FET週期每次移植的活產率等妊娠結局方面，三組間均無顯著差異 (p > 0.05)。

PPOS 方案對整倍體囊胚形成沒有負面影響，

POS 方案的 FET 週期的懷孕結果與GnRH agonist 和 GnRH antagonist 懷孕結果相似

PPOS 有倒排卵時間較短 排卵針劑量較低  取卵數略低於GnRH agonist 和 GnRH antagonist

Analysis of euploidy rates in preimplantation genetic testing for aneuploidy cycles with progestin-primed versus GnRH agonist/antagonist protocol

This study evaluate euploidy rates and pregnancy outcomes in preimplantation genetic testing for aneuploidy (PGT-A) cycles using progestin-primed ovarian stimulation (PPOS) vs  GnRH agonist vs GnRH antagonist protocol.

The euploid blastocyst rate per injected metaphase II(MII) oocytes (14.60% vs. 14.09% vs. 13.94%) was comparable among the three groups (p > 0.05). 

No significant differences were observed among the three groups regarding pregnancy outcomes, including biochemical pregnancy, clinical pregnancy, ongoing pregnancy, implantation, miscarriage, ectopic pregnancy, and live birth rates per transfer in the first FET cycles (p > 0.05).

The PPOS protocol had no negative effect on euploid blastocyst formation, and the pregnancy outcomes in FET cycles using the PPOS protocol were similar to those of the GnRH agonist and antagonist protocols.

Variables	Ovarian stimulation protocol			p value
	PPOS	GnRH agonist	GnRH antagonist
No. of PGT-A cycles	146	160	302
Total dosage of Gn (IU)	1800(1575–2025)	2550(2071.86–3150)	2025(1593.75–2400)	0.000a,b,c
Duration of stimulation (days)	8(7–9)	11.5(10–13)	9(8–9)	0.000a,b,c
Oestradiol level on triggering day (pg/ml)	2420.92(1290–3533.49)	2641(1973.32–3668.44)	2017.36(1268.5–3017)	0.003c
Serum LH level on trigger day (IU/l)	3(1.94–5)	0.86(0.59–1.68)	2(1–3.29)	0.000a,b,c
Progesterone level on trigger day (ng/ml)	1(0.77–1)	0.98(0.71–1.26)	1(0.73–1.32)	0.588
Total No. of retrieved oocytes	1280	1892	2999
No. of retrieved oocytes	7(4–12)	12(7–15)	8(5–13)	0.000a,c
Total No. of MII	1062	1483	2374
No. of MII (n)	6(3–10)	9(6–12)	6(4–11)	0.000a,c
MII rate (%)	82.97%(1062/1280)	78.38%(1483/1892)	79.16%(2374/2999)	0.004a,b
Total No. of oocytes fertilised (n)	815	1014	1716
No. of oocytes fertilised (n)	4.5(2–8)	6(3–9)	5(3–8)	0.014a,c
Oocytes fertilised rate (%)*	76.74%(815/1062)	68.37%(1014/1483)	72.28(1716/2374)	0.000a,b,c
Total No. of cleaving embryos (n)	793	975	1668
Cleavage rate (%)*	97.3%(793/815)	96.15%(975/1014)	97.2%(1668/1716)	0.24
Total No. of blastocyst culture	765	996	1625
Total No. of blastocysts formation	333	454	723
No. of blastocysts formation (n)	2(0–3)	2(1–4)	2(1–4)	0.036a,c
Blastocysts formation rate (%)*	43.53%(333/765)	45.58%(454/996)	44.49%(723/1625)	0.687
Total No. of euploid blastocysts	155	209	331
No. of euploid blastocysts (n)	0(0–2)	1(0–2)	1(0–2)	0.084
Euploid blastocysts rate per biopsy (%)*	46.54%(155/333)	46.04%(209/454)	45.78%(331/723)	0.973
Euploid blastocysts rate per injected MII (%)*	14.60%(155/1062)	14.09%(209/1483)	13.94%(331/2374)	0.878
No. of PGT cycle with no blastocyst (%)	28.1%(41/146)	14.38%(23/160)	21.52%(65/302)	0.013a
No. of PGT cycle with no transferable blastocysts (%)*	51.37%(75/146)	38.75%(62/160)	47.02%(142/302)	0.074