Cumulative Live Birth Rates in Patients with Polycystic Ovary Syndrome: Comparing Progestin Primed Ovarian Stimulation Protocol and GnRH-Antagonist Protocol
Abstract Background: Cumulative live birth rate (CLBR) becomes a comprehensive and meaningful indictor of the success of IVF nowadays. Frozen-embryo transfer (FET) was associated with a higher rate of live birth and a lower risk of the ovarian hyperstimulation syndrome (OHSS) in polycystic ovary syndrome (PCOS) patients. Progestin-primed ovarian stimulation (PPOS) is a new ovarian stimulation protocol in which oral progestin been used to prevent premature luteinizing hormone (LH) surges during ovarian stimulation. The purpose of the current study is to investigate the CLBR of an in vitro fertilization (IVF) cycle in women with PCOS following PPOS protocol compared with gonadotropin releasing hormone (GnRH) antagonist protocol.Methods: It is a retrospective study. The first IVF cycle of 666 PCOS women were included. Ovarian stimulations were performed with PPOS or GnRH antagonist protocol. All patients included in the analysis had either delivered a baby or had used all their embryos of their first stimulated cycle. The patients were followed for 2–7 years until February 2020.Result(s): The CLBR were similar in the PPOS and GnRH antagonist group (64% vs 60.1%, P = 0.748). Logistic regression analyses showed treatment protocol (PPOS vs GnRH antagonist) did not show any significant correlation with the CLBR (adjusted OR: 0.898; 95% CI: 0.583-1.384, P=0.627). No statistically significant differences were found in the live birth rates per embryo transfer (41.3% vs. 38.4%) in the study group and controls.Conclusion(s): The results of this study showed that both the live birth rate per embryo transfer and the cumulative live birth rate were similar between PPOS and GnRH antagonist group. PPOS protocol is efficient in the controlled ovarian stimulation of patients with PCOS.