Pretreatment with oral contraceptives benefit POSEIDON group 1 low prognosis patients during GnRH-antagonist protocol: a propensity score-matched retrospective cohort study.

IF 3.8 3区 医学 Q1 REPRODUCTIVE BIOLOGY
Ning Wu, Xin Li, Cheng Zeng, Jing Shang, Xiuli Yang, Qing Xue
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引用次数: 0

Abstract

Background: Poor ovarian response (POR) is a challenging condition in assisted reproduction technology. Oral contraceptives (OCs) are commonly used to suppress gonadotropin hormone release in POR patients to synchronize the development of antral follicles before ovarian stimulation. Nevertheless, the question of whether such approach confers advantageous outcomes has elicited inconclusive results in previous studies. Therefore, the objective of this study was to investigate the effect of OCs pretreatment in low prognosis patients stratified by Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) criteria.

Methods: This retrospective cohort study included 2,222 patients undergoing their first IVF or ICSI cycle from January 2012 to April 2022. After propensity score matching, 369 patients were in the OC pretreatment group and 879 in the control group. Patients were divided into four subgroups based on the POSEIDON criteria. Comparisons of ovarian response and clinical outcomes were conducted, and multivariable logistic regression was used to assess the association between OCs pretreatment and live birth, clinical pregnancy, and pregnancy loss rates.

Results: Patients in POSEIDON group 1 who received OCs pretreatment exhibited a significant reduction in the dose and duration of gonadotropin administration, along with an increase in the number of oocytes retrieved, 2 pronuclei, available embryos, and good quality embryos, indicating an improvement in their ovarian response to exogenous gonadotropins. Additionally, the live birth rate (P = 0.030) and clinical pregnancy rate (P = 0.012) were significantly higher in the OCs pretreatment group. Multivariate logistic regression analysis demonstrated a positive association between OCs pretreatment and live birth rate (P = 0.008) and clinical pregnancy rate (P = 0.008). However, in POSEIDON group 2 to group 4, there were no significant differences in ovarian response or clinical outcomes between the OCs pretreatment group and the control group.

Conclusions: Administering OCs as pretreatment prior to ovarian stimulation using gonadotrophin releasing hormone antagonist protocol appears to be a more favorable approach than waiting for natural menses in low prognosis patients belonging to POSEIDON group 1.

背景:卵巢反应不良(POR)是辅助生殖技术中的一个难题。口服避孕药(OCs)通常用于抑制POR患者促性腺激素激素的释放,以便在卵巢刺激前同步发育前卵泡。然而,关于这种方法是否会带来有利结果的问题,以往的研究并无定论。因此,本研究的目的是根据患者导向策略(Patient-Oriented Strategies Encompassing Individualized Oocyte Number,POSEIDON)标准分层,探讨OCs预处理对低预后患者的影响:这项回顾性队列研究纳入了2012年1月至2022年4月期间首次接受体外受精或卵胞浆内单精子显微注射(ICSI)周期的2222名患者。经过倾向得分匹配后,369 名患者进入 OC 预处理组,879 名患者进入对照组。根据 POSEIDON 标准将患者分为四个亚组。对卵巢反应和临床结果进行了比较,并使用多变量逻辑回归评估了OCs治疗前与活产率、临床妊娠率和妊娠失败率之间的关系:结果:接受OCs预处理的POSEIDON 1组患者的促性腺激素用药剂量和用药时间显著减少,同时取卵数、2个前核、可用胚胎数和优质胚胎数增加,这表明他们的卵巢对外源性促性腺激素的反应有所改善。此外,OCs 治疗组的活产率(P = 0.030)和临床妊娠率(P = 0.012)也明显较高。多变量逻辑回归分析表明,OCs 预处理与活产率(P = 0.008)和临床妊娠率(P = 0.008)呈正相关。然而,在 POSEIDON 第 2 组至第 4 组中,OCs 预处理组与对照组在卵巢反应或临床结果方面没有显著差异:结论:对于预后较差的 POSEIDON 1 组患者,在使用促性腺激素释放激素拮抗剂方案进行卵巢刺激前使用 OCs 作为预处理似乎比等待自然月经更有利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Ovarian Research
Journal of Ovarian Research REPRODUCTIVE BIOLOGY-
CiteScore
6.20
自引率
2.50%
发文量
125
审稿时长
>12 weeks
期刊介绍: Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.
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