Keywords
ovarian response
desogestrel
oocyte donation
progesteron
How to Cite
Abstract
Study question: Does the use of desogestrel as an LH surge inhibitor affect the outcomes of ovarian stimulation cycles? Summary answer: The use of desogestrel does not negatively affect the outcomes of controlled ovarian stimulation cycles. What is known already: Progestogens such as medroxyprogesterone and dydrogesterone are effective as LH surge inhibitors. Few studies in our region compare the use of desogestrel with GnRH antagonists. Study design: Retrospective cohort study. Materials and Methods: 174 patients who donated oocytes between January 2021 and December 2022 were included. 45 cycles from donors who received 0.075 mg of desogestrel as an LH surge inhibitor were compared with 129 cycles from donors who received GnRH antagonists. Days of stimulation, gonadotropin doses, antral and final follicles, retrieved oocytes, and mature oocytes were compared whith t-tests, Mann-Whitney U tests, and chi-square tests. A p-value<0.05 was considered statistically significant. Main Results: The groups were comparable in terms of antral follicle count (18.5 ± 7.7 vs. 20.5 ± 7.1; NS) and gonadotropin dose (2194 ± 528 vs. 2318 ± 629; NS). There was a slight difference in the number of days of stimulation (9.6 ± 1.2 vs. 10.1 ± 1.6; p = 0.0453). Significant differences favoring desogestrel were obtained in the number of final follicles developed (16.8 ± 8.0 vs. 21.7 ± 9.5; p = 0.0030), oocytes retrieved (15.5 ± 6.8 vs. 18.2 ± 8.3; p = 0.0296), and mature oocytes (12.7 ± 6.3 vs. 15.0 ± 7.1; p = 0.0390). Limitations: This was a retrospective study, which may have introduced bias regarding the choice of treatment. Results after the use of retrieved oocytes were not analyzed. Wider Implications of the findings: Desogestrel is a valid option for inhibiting the LH surge, and it is an easily accesible and convenient option for the donor because it is administered orally.
References
Alexandru, P. C. (2020). Progesting versus GnRH analagues for pituitary suppression during ovarian stimulation for assisted reproductive technology: a sysyematic review and meta- analysis. Obtenido de Reproductive biomedicine online.
Zhang Wanlin, D. X. (7 de May de 2024).
Obtenido de Cumulative Live Birth Rates After the First ART Cycle Using Flexible GnRH Antagonist Protocol vs. Standard Long GnRH Agonist Protocol: A Retrospective Cohort Study in Women of Different Ages. Obtenido de https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.00287/full
B.C. Tarlatiz MD, P. &. (Febrero de 2007). ScienceDirect. Obtenido de GnRH agonists vs antagonists: https://www.sciencedirect. com/science/article/abs/pii/S1521693406001027?via%3Dihub
Duc Thang, L. B. (2024). Non-inferiority of progestin-primed ovarian stimulation versus GnRH antagonist protocol: A propensity score-weighted analysis. Journal of the Formosan Medical Association, 523-529.
S. Hendrickx, C. B. (20 de November de 2023). Obtenido de Progestin primed ovarian stimulation using dydrogesterone from day 7 of the cycle onwards in oocyte donation cycles: a longitudinal study. Obtenido de https://www.rbmojournal.com/article/S1472-6483(23)00831-3/fulltext#
Dong, M., Sun, L., Huang, L., Wang, F., Zhang, X., & Liu, F. (2021). Fixed Gonadotropin-Releasing Hormone Antagonist Protocol Versus Flexible Progestin-Primed Ovarian Stimulation Protocol in Patients With Asynchronous Follicular Development During Controlled Ovulation Stimulation: A Retrospective Study. Frontiers in endocrinology, 12, 690575. https://doi.org/10.3389/fendo.2021.690575
Kuang, Y., Chen, Q., Fu, Y., Wang, Y., Hong, Q., Lyu, Q., Ai, A., & Shoham, Z. (2015). Medroxyprogesterone acetate is an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization. Fertility and sterility, 104(1), 62–70. e3. https://doi.org/10.1016/j.fertnstert.2015.03.022.
Duc Thang, L., Bao Long, H., Thi Thu Trang, D., Ngoc Quy, P., Thi Mai Phuong, G., Thi Hanh, B., Trong Thach, T., Thi Lien Huong, N., Hoang, L., & Hugues, J. N. (2024). Non-inferiority of progestin- primed ovarian stimulation versus GnRH antagonist protocol: A propensity score-weighted analysis. Journal of the Formosan Medical Association = Taiwan yi zhi, 123(4), 523–529. https://doi.org/10.1016/j.jfma.2023.12.008.
Iwami, N., Kawamata, M., Ozawa, N., Yamamoto, T., Watanabe, E., Moriwaka, O.,& Kamiya, H. (2018). New trial of progestin-primed ovarian stimulation usingdydrogesterone versus a typical GnRH antagonistregimen in assisted reproductivetechnology. Archives of gynecology and obstetrics, 298(3), 663–671. https://doi.org/10.1007/s00404-018-4856-8
B.C. Tarlatzis MD, P. &. (February de 2007). ScienceDirect. Obtenido de GnRH agonists vs antagonists: https://www.sciencedirect.com/science/article/abs/pii/
S1521693406001027?via%3Dihub
Beguería, R., García, D., Vassena, R., & Rodríguez, A. (2019). Medroxyprogesterone acetate versus ganirelix in oocyte donation: a randomized controlled trial. Human reproduction (Oxford, England), 34(5), 872–880. https://doi.org/10.1093/humrep/dez034.
Giles, J., Alama, P., Gamiz, P., Vidal, C., Badia, P., Pellicer, A., & Bosch, E. (2021). Medroxyprogesterone acetate is a useful alternative to a gonadotropin-releasing hormone antagonist in oocyte donation: a randomized, controlled trial. Fertility
and sterility, 116(2), 404–412. https://doi.org/10.1016/j.fertnstert.2021.02.036.
Kao, T. C., Hsieh, Y. C., Yang, I. J., Wu, M. Y., Chen, M. J., Yang, J. H., & Chen, S. U. (2023). Progestin-primed ovarian stimulation versus GnRH antagonist protocol in poor responders: Risk of premature LH surge and outcome of oocyte retrieval. Journal of the Formosan Medical Association = Taiwan yi zhi, 122(1), 29–35. https://doi.org/10.1016/j.jfma.2022.08.023
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