Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-3550, Japan.
J Ovarian Res. 2022 Jan 4;15(1):2. doi: 10.1186/s13048-021-00935-5.
Progestin-primed ovarian stimulation (PPOS) has been used in infertility cases in recent years, and several reports have stated that it has oocyte collection results similar to those of gonadotropin-releasing hormone antagonist (GnRH-ant) protocol. For emergency fertility preservation, random-start ovarian stimulation is usually recommended. Therefore we compared the clinical outcomes of random-start PPOS with those of conventional random-start GnRH-ant protocols in fertility-preserving cases.
We retrospectively examined 86 cycles of oocyte collection, of which 56 were random-start GnRH-ant and 30 were random-start PPOS for fertility preservation at our hospital between January 2016 and April 2021. The primary outcome was the number of mature oocytes per cycle. The secondary outcome was the number of vitrified blastocysts per cycle for embryo freezing cases.
No significant differences were noted in the number of days of stimulation, total dose of gonadotropin preparation, and the number of mature oocytes and vitrified blastocysts. The number of hospital visits for monitoring was significantly lower in the PPOS group. The start of menstruation before oocyte collection was significantly less in the PPOS group.
Random-start PPOS and GnRH-ant were similar in oocyte collection results. PPOS can reduce the number of hospital visits, thus reducing patient stress. PPOS at the start of the luteal phase can prevent the start of menstruation during ovarian stimulation.
近年来，孕激素预处理的卵巢刺激（PPOS）已应用于不孕病例，有几项报告称其取卵结果与促性腺激素释放激素拮抗剂（GnRH-ant）方案相似。对于紧急生育力保存，通常推荐随机起始卵巢刺激。因此，我们比较了随机起始 PPOS 与常规随机起始 GnRH-ant 方案在生育力保存病例中的临床结局。
我们回顾性分析了 2016 年 1 月至 2021 年 4 月期间在我院进行的 86 个卵母细胞采集周期，其中 56 个为随机起始 GnRH-ant，30 个为随机起始 PPOS 用于生育力保存。主要结局是每个周期的成熟卵母细胞数。对于胚胎冷冻病例，次要结局是每个周期的可冷冻囊胚数。
两组在刺激天数、促性腺激素制剂总剂量、成熟卵母细胞和可冷冻囊胚数方面无显著差异。PPOS 组的监测就诊次数显著减少。PPOS 组在卵母细胞采集前的月经开始时间显著减少。
随机起始 PPOS 和 GnRH-ant 的取卵结果相似。PPOS 可减少就诊次数，从而减轻患者的压力。黄体期起始 PPOS 可防止卵巢刺激期间月经开始。
