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.
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 |
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