2025年7月9日

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

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