Wang Lu, Wang Jing Yun, Zhang Yuan, Qian Chen, Wang Xiao Hui, Ng Ernest Hung Yu, Ai Ai, Chen Zhi Qin
Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, People's Republic of China.
Department of Obstetrics and Gynaecology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, 999077, People's Republic of China.
Reprod Biol Endocrinol. 2025 May 13;23(1):67. doi: 10.1186/s12958-025-01404-0.
Progestins can block endogenous luteinizing hormone secretion from the pituitary gland and have shown similar efficacy in terms of collecting competent oocytes and embryos; however, some inconsistencies have been proposed by the previous papers regarding the quality of oocytes and embryos obtained with the use of progestins. This study aimed to compare the euploidy rate between women treated with progestin-primed ovarian stimulation (PPOS) and the gonadotropin-releasing hormone (GnRH) antagonist protocol.
This is a prospective randomized study of 240 infertile women undergoing PGT-A between August 2021 and July 2023. Infertile women with advanced maternal age (38-45 years), recurrent pregnancy loss (≥ 2 or 3 consecutive miscarriages), and repeated implantation failure (≥ 4 embryos replaced or ≥ 2 blastocysts replaced without success) undergoing PGT-A cycles were included. Women were randomly assigned into the PPOS group (n = 120) or the antagonist group (n = 120) according to a computer-generated randomization list. Dydrogesterone 20 mg per day was given from the start of ovarian stimulation until the trigger day in the PPOS group. In the antagonist group, an antagonist 0.25 mg was given daily from the sixth day of ovarian stimulation until the trigger day. The primary outcome measure was the euploidy rate, defined as the number of euploid blastocysts per injected oocyte.
No significant differences were observed in the demographic and ovarian stimulation characteristics between the two groups. The euploidy rate was comparable between the PPOS and antagonist group (12.5% vs. 16.0% respectively, P > 0.05). No significant differences were observed between the two groups in positive pregnancy test, clinical pregnancy, miscarriage, ectopic pregnancy, or live birth rates per transfer in the first frozen embryo transfer cycles.
Both PPOS and antagonist protocols had similar euploidy rates in PGT-A cycles.
Clinicaltrials. gov identifier: NCT04989348 ( https://www.
gov/ ). Trial registration date: Clinicaltrials. gov: 30 July 2021.
孕激素可阻断垂体分泌内源性促黄体生成素，在获取合格卵母细胞和胚胎方面显示出相似的疗效；然而，先前的论文对于使用孕激素获得的卵母细胞和胚胎质量存在一些不一致的观点。本研究旨在比较接受孕激素预处理卵巢刺激（PPOS）的女性与促性腺激素释放激素（GnRH）拮抗剂方案治疗的女性的整倍体率。
这是一项对2021年8月至2023年7月期间接受植入前基因检测（PGT-A）的240名不孕女性进行的前瞻性随机研究。纳入接受PGT-A周期治疗的高龄产妇（38 - 45岁）、复发性流产（连续≥2次或3次流产）以及反复种植失败（移植≥4个胚胎或≥2个囊胚均未成功）的不孕女性。根据计算机生成的随机列表，将女性随机分为PPOS组（n = 120）或拮抗剂组（n = 120）。PPOS组从卵巢刺激开始至扳机日每天给予20mg地屈孕酮。拮抗剂组从卵巢刺激第6天至扳机日每天给予0.25mg拮抗剂。主要结局指标为整倍体率，定义为每个注射卵母细胞的整倍体囊胚数量。
两组在人口统计学和卵巢刺激特征方面未观察到显著差异。PPOS组和拮抗剂组的整倍体率相当（分别为12.5%和16.0%，P > 0.05）。在首次冻融胚胎移植周期中，两组在阳性妊娠试验、临床妊娠、流产、异位妊娠或每次移植的活产率方面未观察到显著差异。
在PGT-A周期中，PPOS方案和拮抗剂方案的整倍体率相似。
Clinicaltrials.gov标识符：NCT04989348（https://www.CLINICALTRIALS.gov/）。试验注册日期：Clinicaltrials.gov：2021年7月30日。
