PDF(Pubmed)
Abstract：
UNASSIGNED: In the progestin-primed ovarian stimulation protocol, the oral administration of medroxyprogesterone acetate has been observed to effectively inhibit the LH surge during ovarian stimulation in patients experiencing infertility. Nevertheless, the use of utilizing medroxyprogesterone acetate during ovarian stimulation can result in more pronounced pituitary suppression, potentially necessitating increased doses of gonadotropins and extended treatment durations. Therefore, it is necessary to determine the optimal dose of medroxyprogesterone acetate, aiming to use relatively lower concentrations of medroxyprogesterone acetate to effectively and safely suppress early LH surges.
UNASSIGNED: This retrospective cohort study included 710 patients who underwent cycles of in vitro fertilization or intracytoplasmic sperm injection and were subjected the progestin-primed ovarian stimulation protocol utilizing letrozole between from 1st January 2021 to 31st December 2021. The study population was divided into low, medium, and high concentration groups based on the daily dosage of medroxyprogesterone acetate.The primary focus of this investigation was on the cumulative live birth rate. Secondary outcomes encompassed the occurrence of a premature surge in luteinizing hormone, the quantity of retrieved oocytes, viable embryos, and high-quality embryos, as well as clinical pregnancy rate, abortion rate, ectopic pregnancy rate, and multiple pregnancy rate.
UNASSIGNED: In this study, significant differences were observed among three groups in various parameters including body mass index, baseline levels of Anti-Müllerian hormone and luteinizing hormone, antral follicle count, total dose of gonadotropin, and duration of gonadotropin administration (p<0.05). The number of oocytes and viable embryos were significantly higher in medium group and higher than those in the low dose group. Following adjustments for confounding factors related to medroxyprogesterone acetate for various outcome measures, we conducted multiple regression analysis to investigate the independent effects of daily medroxyprogesterone acetate dosage within the combined progestin-primed ovarian stimulation and letrozole protocol. Following multivariable regression analysis, no disparities were found in embryo characteristics (number of oocytes retrieved, number of available embryos, number of high-quality embryos) or pregnancy outcomes (clinical pregnancy rate, cumulative live birth rate) among the three groups.
UNASSIGNED: Progestin-primed ovarian stimulation with letrozole using different dose of medroxyprogesterone acetate per day was comparable in terms of the number of oocytes retrieved, the number of high-quality embryos, clinical pregnancy rate and cumulative live birth rate after frozen embryo transfer.
UNASSIGNED: This retrospective cohort study included 710 patients who underwent cycles of in vitro fertilization or intracytoplasmic sperm injection and were subjected the progestin-primed ovarian stimulation protocol utilizing letrozole between from 1st January 2021 to 31st December 2021. The study population was divided into low, medium, and high concentration groups based on the daily dosage of medroxyprogesterone acetate.The primary focus of this investigation was on the cumulative live birth rate. Secondary outcomes encompassed the occurrence of a premature surge in luteinizing hormone, the quantity of retrieved oocytes, viable embryos, and high-quality embryos, as well as clinical pregnancy rate, abortion rate, ectopic pregnancy rate, and multiple pregnancy rate.
UNASSIGNED: In this study, significant differences were observed among three groups in various parameters including body mass index, baseline levels of Anti-Müllerian hormone and luteinizing hormone, antral follicle count, total dose of gonadotropin, and duration of gonadotropin administration (p<0.05). The number of oocytes and viable embryos were significantly higher in medium group and higher than those in the low dose group. Following adjustments for confounding factors related to medroxyprogesterone acetate for various outcome measures, we conducted multiple regression analysis to investigate the independent effects of daily medroxyprogesterone acetate dosage within the combined progestin-primed ovarian stimulation and letrozole protocol. Following multivariable regression analysis, no disparities were found in embryo characteristics (number of oocytes retrieved, number of available embryos, number of high-quality embryos) or pregnancy outcomes (clinical pregnancy rate, cumulative live birth rate) among the three groups.
UNASSIGNED: Progestin-primed ovarian stimulation with letrozole using different dose of medroxyprogesterone acetate per day was comparable in terms of the number of oocytes retrieved, the number of high-quality embryos, clinical pregnancy rate and cumulative live birth rate after frozen embryo transfer.
摘要：
■在孕激素引发的卵巢刺激方案中，已观察到口服醋酸甲羟孕酮可有效抑制不孕患者卵巢刺激期间的LH激增。然而，在卵巢刺激期间使用醋酸甲羟孕酮可以导致更明显的垂体抑制，可能需要增加促性腺激素剂量和延长治疗持续时间。因此,有必要确定醋酸甲羟孕酮的最佳剂量，旨在使用相对较低浓度的醋酸甲羟孕酮来有效和安全地抑制早期LH激增。
这项回顾性队列研究包括710例患者，这些患者在2021年1月1日至2021年12月31日期间接受了体外受精或卵胞浆内单精子注射周期，并使用来曲唑接受了孕激素引发的卵巢刺激方案。研究人群分为低，中等,和高浓度组基于醋酸甲羟孕酮的每日剂量。这项调查的主要重点是累积活产率。次要结局包括黄体生成素过早激增的发生，回收的卵母细胞的数量，有活力的胚胎,和高质量的胚胎，以及临床妊娠率，流产率,异位妊娠率,和多胎妊娠率。
■在这项研究中，在三组中观察到各种参数的显着差异，包括体重指数，抗苗勒管激素和黄体生成素的基线水平，窦卵泡计数,促性腺激素的总剂量，和促性腺激素给药的持续时间（p<0.05）。中剂量组的卵母细胞数和有活力的胚胎数明显高于低剂量组。在调整与醋酸甲羟孕酮相关的混杂因素后，我们进行了多元回归分析,以研究孕激素促排卵和来曲唑联合方案中醋酸甲羟孕酮每日剂量的独立影响.在多元回归分析后，在胚胎特征中没有发现差异(回收的卵母细胞数量，可用胚胎的数量，高质量胚胎的数量)或妊娠结局(临床妊娠率，累计活产率)。
每天使用不同剂量的醋酸甲羟孕酮来曲唑的孕激素促排卵在回收的卵母细胞数量方面具有可比性，高质量胚胎的数量，冷冻胚胎移植后的临床妊娠率和累积活产率。
这项回顾性队列研究包括710例患者，这些患者在2021年1月1日至2021年12月31日期间接受了体外受精或卵胞浆内单精子注射周期，并使用来曲唑接受了孕激素引发的卵巢刺激方案。研究人群分为低，中等,和高浓度组基于醋酸甲羟孕酮的每日剂量。这项调查的主要重点是累积活产率。次要结局包括黄体生成素过早激增的发生，回收的卵母细胞的数量，有活力的胚胎,和高质量的胚胎，以及临床妊娠率，流产率,异位妊娠率,和多胎妊娠率。
■在这项研究中，在三组中观察到各种参数的显着差异，包括体重指数，抗苗勒管激素和黄体生成素的基线水平，窦卵泡计数,促性腺激素的总剂量，和促性腺激素给药的持续时间（p<0.05）。中剂量组的卵母细胞数和有活力的胚胎数明显高于低剂量组。在调整与醋酸甲羟孕酮相关的混杂因素后，我们进行了多元回归分析,以研究孕激素促排卵和来曲唑联合方案中醋酸甲羟孕酮每日剂量的独立影响.在多元回归分析后，在胚胎特征中没有发现差异(回收的卵母细胞数量，可用胚胎的数量，高质量胚胎的数量)或妊娠结局(临床妊娠率，累计活产率)。
每天使用不同剂量的醋酸甲羟孕酮来曲唑的孕激素促排卵在回收的卵母细胞数量方面具有可比性，高质量胚胎的数量，冷冻胚胎移植后的临床妊娠率和累积活产率。
