Medroxyprogesterone acetate used in ovarian stimulation is associated with reduced mature oocyte retrieval and blastocyst development: a matched cohort study of 825 freeze-all IVF cycles

Ozgur K., Berkkanoglu M., Bulut H., DÖNMEZ L., Coetzee K.

JOURNAL OF ASSISTED REPRODUCTION AND GENETICS, cilt.37, sa.9, ss.2337-2345, 2020 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 37 Sayı: 9
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1007/s10815-020-01894-4
  • Dergi Adı: JOURNAL OF ASSISTED REPRODUCTION AND GENETICS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, ATLA Religion Database, BIOSIS, Biotechnology Research Abstracts, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.2337-2345
  • Anahtar Kelimeler: Medroxyprogesterone acetate, Flexible start, Co-treatment, Ovarian stimulation, Freeze-all IVF, IN-VITRO FERTILIZATION, LUTEINIZING-HORMONE SURGES, FROZEN EMBRYO-TRANSFER, WOMEN, HYPERSTIMULATION, PROGESTERONE, PREGNANCY, UTROGESTAN, FRESH, RATES
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Purpose To compare the effectivity of flexible-start medroxyprogesterone acetate (MPA) co-treatment ovarian stimulations (OS) with flexible-start gonadotropin-releasing hormone antagonist (GnRH-ant) co-treatment OS, in blastocyst freeze-all IVF cycles. Method This matched cohort study was performed at a single IVF center. Study cycles were extracted from freeze-all IVF cycles performed between February 2015 and June 2018 with cycles grouped according to the co-treatment protocol (MPA and GnRH-ant groups) used. MPA cycles were matched 1:1 using antral follicle count, female age, infertility duration, and female body mass index, with GnRH-ant cycles, resulting in 825 matched cycles. MPA or CET co-treatment was started when leading follicles reached 11-12 mm. Results Duration of OS was significantly longer, and total FSH dose was significantly higher in the MPA group. Numbers of mature oocytes retrieved were similar; however, the mature oocyte retrieval rate (83.8 vs. 97.1%;p< 0.001), number of blastocysts, blastocyst rate (36.4 vs. 41.4%;p< 0.001) and > 2 viable blastocyst rate were all significantly lower in the MPA group. The live birth (LB) per transfer rates (51.6 vs. 55.7%;p= 0.155) were similar; however, the LB rate per treatment was significantly lower (40.9 vs. 45.8%;p= 0.05). A linear regression included the OS co-treatment protocol (GnRH-ant; 1.4 (1.07-1.81);p= 0.013) in the final model to predict having > 2 viable blastocysts. Conclusion Flexible-start MPA co-treatment OS was as effective in freeze-all IVF cycles as GnRH-ant co-treatment, with similar LB per transfer rates; however, increased cycle cancellation and reduced blastocyst numbers reduced LB per treatment rates significantly.