Effectofprogestin-primedovarianstimulationprotocolininfertilewomenwithbasalfollicle-stimulatinghormonelevels≥15IU/L:Aretrospectiveanalysis

LuFang,Xiu-JuanQi,HongZhu

Abstract:

Objective:

Toevaluatetheefficacyofprogestin-primedovarianstimulation(PPOS)protocolininfertilewomenwithhighbasalfollicle-stimulatinghormone(FSH)levels≥15IU/L.

Methods:

PatientswithhighbasalFSHlevels≥15IU/LwithautologousoocytesfromSeptembertoMarchwerereviewed.Eithermedroxyprogesteroneacetate4mg/dorclomiphenecitrate(CC)50mg/dwasadministereddailyfromday3tothetriggerday.WhenserumFSHlevelsdecreasedto≤15.0IU/L,alowdoseofhumanmenopausalgonadotropin(hMG)75/IU/dwasadministeredtopromotelatefolliculardevelopment.

Results:

Twohundredandtwentywomenwereretrospectivelyanalyzedinthisstudy.Amongthem,patientswereadministeredwithPPOSprotocolasthestudygroup,and81patientswereadministeredwithCCprotocolasthecontrolgroup.Thenumbersofreceivedoocytesandviableembryoswerehigherinthestudygroupthanthoseinthecontrolgroup(1.5±1.2vs.1.2±0.8and0.8±0.8vs.0.5±0.6,respectively,P0.05).However,hMGdurationanddosageweresignificantlyhigherinthestudygroupthanthoseinthecontrolgroup(4.2±2.7dvs.1.1±2.3dand.1±.5IUvs..7±.3IU,respectively,P0.01).Incidenceofluteinizinghormonesurgeandcyclecancellationratewerelowerinthestudygroupthanthoseinthecontrolgroupwithstatisticaldifference(2.88%vs.16.05%and36.50%vs.50.63%,respectively,P0.05).

Conclusions:

PPOSprotocolcaneffectivelydownregulatetheendogenousFSHlevels.ComparedwithCCprotocol,treatmentwithPPOSprotocolinpatientswithhighbasalFSHlevels≥15IU/Lcouldreceivemoreoocytesandmoreviableembryos.

Keywords:

DiminishedOvarianReserve;Follicle-StimulatingHormone;InvitroFertilization;Progestin-PrimedOvarianStimulationProtocol