Division of Reproductive Endocrinology and IVF Unit of the Başkent University Obstetrics and Gynecology Clinic of the Başkent University Adana Dr. Turgut Noyan Research and Application Center, Kazım Karabekir Mah. Gülhatmi Cad. No:37 Yüreğir, Adana, Turkey.
Esra Bulgan Kılıçdağ Clinic, Adana, Turkey.
Arch Gynecol Obstet. 2024 Nov;310(5):2657-2662. doi: 10.1007/s00404-024-07756-z. Epub 2024 Oct 2.
Recently, progesterone has been used to prevent LH surge instead of GnRH analogues during ART treatments, which is known as progesterone-primed ovarian stimulation (PPOS) protocol. During ART treatment, highly purified human menopausal gonadotropin (HP-hMG) and recombinant follicle stimulating hormone (rFSH) are two of the agents used for stimulation of antral follicles. The aim of this study is to compare the efficacy and success of HP-hMG and rFSH agents in the ovarian stimulation step of the PPOS protocol, which has not been previously reported in the literature.
This retrospective study was conducted at a university hospital with patients who underwent IVF treatment using PPOS protocols in between January 2019 and July 2021. For ovarian stimulation, rFSH was used in group I and HP-hMG was used in group II. Mature oocyte ratio was the primary outcome, and live birth rate was the secondary outcome. Mann-Whitney and Chi-square tests were used for statistical analysis. All p values below 0.05 were considered significant.
Total numbers of follicles, oocytes, MII, and 2PN numbers obtained were similar between the two groups. The fertilization rates were 66.7% in the rFSH group and 64.3% in the HP-hMG group (p > 0.05). The pregnancy rates were 53.5% and 46.7% in the rFSH and HP-hMG groups, respectively. There was no statistically significant difference between pregnancy, abortus, and live birth rates.
In this study, it is demonstrated that stimulation of oocytes with either rFSH or hMG in the PPOS protocol, which has been added to IVF treatment protocols in recent years, had no statistical difference regarding mature oocyte numbers and live birth rates between the two groups. These results are consistent with the previous literature which compared rFSH and hMG in GnRH agonist and antagonist protocols.
最近，孕激素被用于 ART 治疗中预防 LH 峰，而不是 GnRH 类似物，这被称为孕激素预刺激（PPOS）方案。在 ART 治疗中，高纯度人绝经期促性腺激素（HP-hMG）和重组卵泡刺激素（rFSH）是两种用于刺激窦卵泡的药物。本研究旨在比较 PPOS 方案中卵巢刺激步骤中 HP-hMG 和 rFSH 药物的疗效和成功率，这在文献中尚未报道过。
这是一项在大学医院进行的回顾性研究，研究对象为 2019 年 1 月至 2021 年 7 月期间接受 PPOS 方案的 IVF 治疗的患者。卵巢刺激中，rFSH 用于组 I，HP-hMG 用于组 II。主要结局是成熟卵母细胞比例，次要结局是活产率。采用 Mann-Whitney 和卡方检验进行统计学分析。所有 p 值均<0.05 被认为有统计学意义。
两组患者的总卵泡数、卵母细胞数、MII 数和 2PN 数相似。rFSH 组的受精率为 66.7%，HP-hMG 组为 64.3%（p>0.05）。rFSH 组和 HP-hMG 组的妊娠率分别为 53.5%和 46.7%。两组妊娠、流产和活产率无统计学差异。
本研究表明，在近年来添加到 IVF 治疗方案中的 PPOS 方案中，用 rFSH 或 hMG 刺激卵母细胞，两组在成熟卵母细胞数量和活产率方面没有统计学差异。这些结果与之前比较 GnRH 激动剂和拮抗剂方案中 rFSH 和 hMG 的文献一致。
