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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.

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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