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在PPOS方案前使用复方口服避孕药对卵子捐赠者和接受者结局的影响:一项国际多中心回顾性研究

Influence of combined oral contraceptive pill before PPOS protocol on egg donors and recipients' outcomes: an international multicenter retrospective study.

作者信息

Maggi Sara, Bontà Silvia, Forgiarini Antonio, Lammens Greet, Franzò Simona, Zamagni Giulia, Parmegiani Lodovico, Zito Gabriella, Ricci Giuseppe, Espinel Luis Alberto Quintero

机构信息

Gametia-Next Fertility Valencia, Valencia, Spain.

Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.

出版信息

J Assist Reprod Genet. 2025 May 29. doi: 10.1007/s10815-025-03519-0.

DOI:10.1007/s10815-025-03519-0
PMID:40439989
Abstract

PURPOSE

This study aims to evaluate whether using a combined oral contraceptive pill (COCP) pre-treatment before controlled ovarian hyperstimulation (COH) may negatively influence ovarian response in donors and treatments outcomes in recipients when a progestin-primed ovarian stimulation (PPOS) protocol is used in oocyte donation treatments.

METHODS

Multicenter retrospective cohort study evaluating outcomes of 397 COH cycles in oocyte donors, with and without COCP pre-treatment. The retrieved oocytes were used for 216 oocyte donation cycles in recipients.

RESULTS

In donors, the No-COCP group obtained a higher number of total, MII, and useful oocytes, similar stimulation days, total FSH dose used, and cancellation rate due to low response, while the COCP group showed significantly higher cancellations for low LH levels, indicative of long-lasting pituitary suppression COCP related. In recipients, both groups showed similar fertilization rate and blastocyst formation rate. Miscarriage rate (MR) was significantly higher in the COCP group, while higher implantation rate, ongoing pregnancy rate (OPR), and live birth rate (LBR) were obtained in the No-COCP group.

CONCLUSIONS

Donor response to COH with PPOS protocol appears to be negatively influenced by COCP pre-treatment, with implications for oocyte donation treatment outcomes in recipients, including higher MR and lower OPR/LBR. Further studies are needed to confirm these findings.

摘要

目的

本研究旨在评估在卵母细胞捐赠治疗中使用孕激素预处理卵巢刺激(PPOS)方案时,在控制性卵巢刺激(COH)前使用复方口服避孕药(COCP)预处理是否会对供体的卵巢反应以及受体的治疗结局产生负面影响。

方法

多中心回顾性队列研究,评估了397个卵母细胞供体的COH周期的结局,这些周期有或没有COCP预处理。回收的卵母细胞用于216个受体的卵母细胞捐赠周期。

结果

在供体中,未使用COCP组获得的总卵母细胞、MII期卵母细胞和可用卵母细胞数量更多,刺激天数、使用的总FSH剂量以及因低反应导致的取消率相似,而COCP组因LH水平低导致的取消率显著更高,表明与COCP相关的垂体长期抑制。在受体中,两组的受精率和囊胚形成率相似。COCP组的流产率(MR)显著更高,而未使用COCP组的着床率、持续妊娠率(OPR)和活产率(LBR)更高。

结论

PPOS方案的COH中供体的反应似乎受到COCP预处理的负面影响,这对受体的卵母细胞捐赠治疗结局有影响,包括更高的MR和更低的OPR/LBR。需要进一步研究来证实这些发现。

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本文引用的文献

1
Clinical and laboratory key performance indicators in IVF: A consensus between the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR) and the Italian Society of Embryology, Reproduction and Research (SIERR).辅助生殖技术中临床和实验室关键绩效指标:意大利生育与不育学会(SIFES-MR)和意大利胚胎学、生殖与研究学会(SIERR)的共识
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Comparison of euploidy rates of blastocysts in women treated with progestins or GnRH antagonist to prevent the luteinizing hormone surge during ovarian stimulation.比较使用孕激素或 GnRH 拮抗剂预防卵巢刺激中黄体生成素峰时胚胎中整倍体率。
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Predicting suboptimal oocyte yield following GnRH agonist trigger by measuring serum LH at the start of ovarian stimulation.通过在卵巢刺激开始时测量血清 LH 预测 GnRH 激动剂触发后卵母细胞产量不佳。
Hum Reprod. 2019 Oct 2;34(10):2027-2035. doi: 10.1093/humrep/dez132.
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Effect of pretreatment with combined oral contraceptives on outcomes of assisted reproductive technology for women with polycystic ovary syndrome: a meta-analysis.联合口服避孕药预处理对多囊卵巢综合征妇女辅助生殖技术结局的影响:一项荟萃分析。
Arch Gynecol Obstet. 2019 Sep;300(3):737-750. doi: 10.1007/s00404-019-05210-z. Epub 2019 Jun 6.
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New stimulation regimens: endogenous and exogenous progesterone use to block the LH surge during ovarian stimulation for IVF.新的刺激方案:在 IVF 卵巢刺激过程中使用内源性和外源性孕激素来阻断 LH 峰。
Hum Reprod Update. 2017 Mar 1;23(2):211-220. doi: 10.1093/humupd/dmw047.
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Effect of pretreatment with oral contraceptives and progestins on IVF outcomes in women with polycystic ovary syndrome.口服避孕药和孕激素预处理对多囊卵巢综合征女性体外受精结局的影响。
Hum Reprod. 2017 Feb;32(2):354-361. doi: 10.1093/humrep/dew325. Epub 2016 Dec 19.
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Dual trigger for final oocyte maturation improves the oocyte retrieval rate of suboptimal responders to gonadotropin-releasing hormone agonist.双重触发促进最终卵母细胞成熟可提高对促性腺激素释放激素激动剂反应欠佳者的卵母细胞采集率。
Fertil Steril. 2016 Nov;106(6):1356-1362. doi: 10.1016/j.fertnstert.2016.07.1068. Epub 2016 Aug 1.
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Assessing the adequacy of gonadotropin-releasing hormone agonist leuprolide to trigger oocyte maturation and management of inadequate response.评估促性腺激素释放激素激动剂亮丙瑞林触发卵母细胞成熟的充分性和处理反应不足。
Fertil Steril. 2016 Oct;106(5):1093-1100.e3. doi: 10.1016/j.fertnstert.2016.06.013. Epub 2016 Jun 21.
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Agonist depot versus OCP programming of frozen embryo transfer: a retrospective analysis of freeze-all cycles.激动剂长效注射剂与口服避孕药用于冷冻胚胎移植的方案:冻存全胚周期的回顾性分析
J Assist Reprod Genet. 2016 Feb;33(2):207-14. doi: 10.1007/s10815-015-0639-3. Epub 2015 Dec 23.
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Risk factors for a suboptimal response to gonadotropin-releasing hormone agonist trigger during in vitro fertilization cycles.体外受精周期中促性腺激素释放激素激动剂扳机反应欠佳的危险因素。
Fertil Steril. 2015 Sep;104(3):637-42. doi: 10.1016/j.fertnstert.2015.06.011. Epub 2015 Jul 3.