Minerva obstetrics and gynecology最新文献

{"title":"Sequential combined approach in patients with mixed urinary incontinence: surgery followed by posterior tibial nerve stimulation.","authors":"Valerio Carletti, Veronica Yacoub, Debora Grilli, Claudia Morgani, Pier L Palazzetti, Marzio A Zullo, Paolo Luffarelli, Herbert C Valensise, Francesco Maneschi, Vincenzo Spina, Michele C Schiavi","doi":"10.23736/S2724-606X.22.05106-5","DOIUrl":"10.23736/S2724-606X.22.05106-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to demonstrate the efficacy of sequential combined treatment with transobturator tape (TOT) followed by posterior tibial nerve stimulation (PTNS) in patients with mixed urinary incontinence (MUI); quality of life and patients' satisfaction was also assessed.</p><p><strong>Methods: </strong>Retrospective analysis on women affected by MUI with prevalent Stress Urinary Incontinence (SUI) component. Women, divided in 2 groups, underwent different treatments, TOT vs. TOT+PTNS. Population was assessed by medical history, previous pelvic surgery, clinical exam, urodynamic exams, pelvic ultrasound examination, and questionnaires (The International Consultation on Incontinence Questionnaire Short Form, Overactive Bladder Questionnaire, Health Related Quality of Life) comparing them before and after 12 weeks after treatment.</p><p><strong>Results: </strong>One hundred twelve women were enrolled in the study. The mean age was 57.96±7.34 in the first group (N.=60) and 58.29±6.14 in the second group (N.=52). Peak flow (mL/s) statistically improved after treatment, 22.23±4.29 (TOT) vs. 24.81±5.8 (TOT+PTNS). First voiding desire (mL) improved significantly between the two groups 108.72±19.24 vs. 142.43±19.98. Maximum cystometric capacity (mL) in the TOT group at 12-weeks was 328.76±82.44 vs. TOT+PTNS group of 396.26±91.21. Detrusor pressure at peak flow(cmH2O) showed a greater improvement in TOT+PTNS than TOT alone 14.45±6.10 vs. 11.89±54.49. At 12-week, urinary diary and quality of life improved in terms of urgent urination events, mean number of voids, urge symptoms and nocturia events. The Patient Impression of Global Improvement (PGI-I) after 3 months was better in combined group.</p><p><strong>Conclusions: </strong>Combined and sequential TOT+PTNS is more effective compared to TOT alone in MUI patients with prevalent SUI component.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40561559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and future methods for embryo selection: on a quest for reliable strategies to reduce time to pregnancy.","authors":"Francesco Capodanno, Attilio Anastasi, Marialuisa Cinti, Francesca Bonesi, Andrea Gallinelli","doi":"10.23736/S2724-606X.23.05257-0","DOIUrl":"10.23736/S2724-606X.23.05257-0","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to analyze the usefulness of the principal embryological strategies to reduce time to pregnancy.</p><p><strong>Evidence acquisition: </strong>A systematic search of publications in the PubMed/MEDLINE, Embase and Scopus databases from inception to present including \"IVF,\" \"blastocyst,\" \"embryo colture,\" \"competent embryo,\" \"time to pregnancy,\" \"aneuploid,\" \"euploid,\" \"vitrification,\" \"preimplantation genetic,\" \"IVF strategies\" and \"embryo selection\" alone or in combinations has been done.</p><p><strong>Evidence synthesis: </strong>We have selected 230 articles and 9 of them have been included in this mini-review.</p><p><strong>Conclusions: </strong>Several embryological strategies aimed to select the most competent embryo and reduce time to pregnancy have been proposed, even if few publications on this specific topic are available. preimplantation genetic testing (PGT-A) represents the unique method able to assess the embryonic chromosomal status, but this does not mean that PGT-A is a reliable strategy to reduce time to pregnancy. There is no consensus on a specific method to reduce time to pregnancy, nevertheless this final goal could be probably reached through a harmonious combination of procedures. Thus, a reliable strategy to reduce time to pregnancy could be achieved when embryo culture, embryo cryopreservation and PGT-A are perfectly integrated and appropriately offered to selected patients.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9432356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of pregnancy and childbirth in a patient with glutaric aciduria type II.","authors":"Stefano Restaino, Alessia Sala, Marta Angelini, Valentina Zanin, Alice Poli, Cristina Angeli, Francesca Ferrara, Vanni Pezzarini, Giuseppe Vizzielli, Lorenza Driul","doi":"10.23736/S2724-606X.22.05121-1","DOIUrl":"10.23736/S2724-606X.22.05121-1","url":null,"abstract":"<p><p>Glutaric aciduria type II (GA II) is a genetic disorder that interferes with the body's ability to break down proteins and fats to produce energy. Signs and symptoms vary greatly depending on the age of onset and severity of the condition. Pregnancy may be a high-risk period in women affected by metabolic disorders, because the mother must guarantee wellness for both her and fetus. A 37-year-old primigravida woman affected by a mild form of GA II presented to our high-risk department. During pregnancy a dietician strictly controlled her diet and nutritional intake. The fetal growth was regular but around the 38^th week a polyhydramnios was diagnosed. A modification in carbohydrate intake led to a normal amniotic fluid. Considering the high risk of metabolic decompensation during labor, an elective cesarean section was programmed. The rare disease geneticist gave some indications to follow before, during and after delivery to reduce the risk for the mother. No complications occurred and the patient with her baby was discharged on the third postoperative day. We present a case report and a review of literature. In pregnant women affected by GA II periodical nutritional and obstetrical evaluations are important to monitor maternal condition and fetal growth. Adequate nutrient intake is fundamental to preserve mother and fetus from complications. Elective caesarean section is preferred to reduce metabolic distress during delivery and to avoid the risk of metabolic crisis. Pregnant women with metabolic diseases are increasing, consequently guidelines may be necessary for a better management.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40338889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and laboratory features in women with different phenotypes of polycystic ovary syndrome.","authors":"Aghdas Safari, Ali Mosadeghkhah, Maryam K Khameneie","doi":"10.23736/S2724-606X.22.05124-7","DOIUrl":"10.23736/S2724-606X.22.05124-7","url":null,"abstract":"<p><strong>Background: </strong>Misdiagnosis is still an obstacle in the workup of polycystic ovary syndrome. We compared patients' characteristics among phenotypes of the syndrome and assessed the association of the characteristics with oligo-anovulation, hyperandrogenism, and polycystic ovary.</p><p><strong>Methods: </strong>In the infertility department of a teaching hospital, we performed a cross-sectional study. Based on the Rotterdam Criteria, we included 136 patients with polycystic ovary syndrome and 46 healthy controls.</p><p><strong>Results: </strong>The most common phenotype was A (N.=45;33%). Overall, A and C had larger Body Mass Index (P=0.019 and 0.030, respectively) and waist circumference (P=0.005 and 0.003) than control. Also, A and D had higher serum anti-mullerian hormone than control (both P<0.001) or phenotype C (P<0.001 and 0.01). Phenotypes A and C had higher insulin than control (both P=0.004). The highest level of estradiol was for control and the lowest for B. The lowest high-density lipoprotein was for C; and A to C phenotypes had higher triglyceride than control (P=0.002, <0.001, and 0.041). Larger body mass was associated with hyperandrogenism (adjusted Odds Ratio 95% CI=1.11 [1.01, 1.23], P=0.034); higher anti-mullerian hormone and high-density lipoprotein were related to oligo-anovulation (1.2 [1.07, 1.37], P=0.004; 1.1 [1.00, 1.13], P=0.041). Higher insulin and lower high-density lipoprotein were associated with polycystic ovary (1.11 [1.03, 1.21], P=0.013; 0.9 [0.82, 0.97], P=0.014).</p><p><strong>Conclusions: </strong>There are potentials in Body Mass Index, waist circumference, serum anti-mullerian hormone, insulin, estradiol, high-density lipoprotein, and triglyceride concentration for differentiating the phenotypes of polycystic ovary syndrome and for more precise diagnosis of hyperandrogenism, oligo-anovulation, and polycystic ovary morphology.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40591418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mosaic embryo: what it means for the doctor and the patient.","authors":"Ermanno Greco, Pier F Greco, Ilaria Listorti, Carlo Ronsini, Francesco Cucinelli, Anil Biricik, Manuel Viotti, Noemi Meschino, Francesca Spinella","doi":"10.23736/S2724-606X.23.05281-8","DOIUrl":"10.23736/S2724-606X.23.05281-8","url":null,"abstract":"<p><strong>Introduction: </strong>Mosaic embryos are embryos that on preimplantation genetic analysis are found to be composed of euploid and aneuploid cells. Although most of these embryos do not implant when transferred into the uterus following IVF treatment, some may implant and are capable of giving rise to babies.</p><p><strong>Evidence acquisition: </strong>There is currently an increasing number of reports of live births following the transfer of mosaic embryos. Compared to euploid, mosaic embryos have lower implantation rates and higher rates of miscarriage, and occasionally aneuploid component persists. However, their outcome is better than that obtained after the transfer of embryos consisting entirely of aneuploid cells. After implantation, the ability to develop into a full-term pregnancy is influenced by the amount and type of chromosomal mosaicism present in a mosaic embryo. Nowadays many experts in the reproductive field consider mosaic transfers as an option when no euploid embryos are available. Genetic counseling is an important part of educating patients about the likelihood of having a pregnancy with healthy baby but also on the risk that mosaicism could persist and result in liveborn with chromosomal abnormality. Each situation needs to be assessed on a case-by-case basis and counseled accordingly.</p><p><strong>Evidence synthesis: </strong>So far, the transfers of 2155 mosaic embryos have been documented and 440 live births resulting in healthy babies have been reported. In addition, in the literature to date, there are 6 cases in which embryonic mosaicism persisted.</p><p><strong>Conclusions: </strong>In conclusion, the available data indicate that mosaic embryos have the potential to implant and develop into healthy babies, albeit with lower success rates than euploids. Further clinical outcomes should be collected to better establish a refined ranking of embryos to transfer.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9767082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trophoblast microRNAs, pre-eclampsia and intrauterine growth restriction.","authors":"Elisa Spataro, Lucia Pasquini, Cristina Luceri, Felice Petraglia","doi":"10.23736/S2724-606X.22.05109-0","DOIUrl":"10.23736/S2724-606X.22.05109-0","url":null,"abstract":"<p><p>MicroRNAs (miRNAs) are small single-stranded non-coding RNA molecules that play a role in regulating gene expression in a tissue-specific manner. Placental miRNAs expression pattern dynamically changes during pregnancy influencing cell proliferation, differentiation and apoptosis. Changes of specific miRNA levels have been described in pregnancies complicated by hypertensive disorders or gestational diabetes and a growing interest in understanding miRNA role on placental development and placental disorders is currently going on. The present review evaluates the possible roles of miRNAs in trophoblastic invasion and placental development as well as their potential role as biomarkers for the prediction of placental disorders focusing the attention on intrauterine growth restriction.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction of labor with repeated prostaglandin administration after failure of dinoprostone vaginal insert: a retrospective study comparing dinoprostone and misoprostol.","authors":"Matteo Mancarella, Diego Costa Torro, Giulia Moggio, Valentina E Bounous, Nicoletta Biglia","doi":"10.23736/S2724-606X.23.05414-3","DOIUrl":"https://doi.org/10.23736/S2724-606X.23.05414-3","url":null,"abstract":"<p><strong>Background: </strong>Induction of labor in women with unfavorable cervix can be started with cervical ripening by dinoprostone vaginal insert. In cases of unsuccessful response, management is unclear: a possible option is a repeated induction with prostaglandins. The aim of this study was to assess the results of a second induction by either dinoprostone or misoprostol, comparing those treatments.</p><p><strong>Methods: </strong>A retrospective analysis was carried out on a cohort of 109 women with unsuccesful response to a first attempt of induction with dinoprostone vaginal insert, who required a second stimulation by either dinoprostone vaginal gel (56 patients) or oral misoprostol (53 patients). The outcomes assessed where the rates of active labor and vaginal delivery, and secondarily maternal and perinatal adverse events.</p><p><strong>Results: </strong>Overall 70.6% of patients reached active labor and 62.4% had a vaginal delivery; the efficacy of the double induction was similar for dinoprostone vaginal gel and oral misoprostol, with active labor in 69.6% and 71.7% (P=0.83), and vaginal delivery in 62.5% and 62.3% of patients (P=0.99) respectively. The incidence of adverse events was low, with no perinatal complications and similar rates of maternal complications, notably major post-partum hemorrhage in 1.8% and 3.8% of patients (P=0.61) for dinoprostone and misoprostol respectively.</p><p><strong>Conclusions: </strong>Dinoprostone vaginal gel and oral misoprostol as a second cycle of induction appear to be both effective in achieving active labor and vaginal delivery after failure of dinoprostone vaginal insert, without a significant rate of adverse events.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of combined hormonal contraceptive for in-vitro fertilization cycle priming is not associated with decreased pregnancy rate in frozen embryo transfer cycles: a cohort study.","authors":"Kristy K Cho, Chen Jing, Niamh M Tallon","doi":"10.23736/S2724-606X.23.05408-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.23.05408-8","url":null,"abstract":"<p><strong>Background: </strong>The objectives of this study are to evaluate the cycle outcomes from IVF treatment preceded by oral contraceptive pills (OCP) priming compared to estradiol pretreatment and to determine if there is a role for OCP priming for those undergoing frozen embryo transfers.</p><p><strong>Methods: </strong>The study took place at a university-affiliated fertility center in Canada. The study included in-vitro fertilization (IVF) antagonist cycles from Jan 2016 to Jun 2019. Those with protocol deviation or treatment cancellation were excluded.</p><p><strong>Results: </strong>There were 2237 cycles by 1958 patients; 27% of cycles utilized OCP priming. The average age in the OCP group was 34 years old compared to 36.5 in the estradiol group (P<0.01). AMH was reported in 43% of patients and was 3.7ng/mL in the OCP group versus 2.2 ng/mL in the estradiol group (P<0.01). The number of oocytes (15.2 vs. 12.5) and number of blastocysts (4.6 vs. 3.3) were higher in the OCP group (P all <0.01). After adjusting for age and AMH with linear regression for the 978 cycles with recorded AMH (24% with OCP prime), a significantly higher number of oocytes (13.8 vs. 11.9, P=0.002) was still noted in the OCP group. There were 866 euploid embryo transfer cycles (28% with OCP prime). There were no significant differences in implantation (77% vs. 76%) or ongoing pregnancy rates (56% vs. 54%) between those who had a frozen embryo transfer after OCP primed compared to estradiol primed stimulation cycles (P all >0.6).</p><p><strong>Conclusions: </strong>There were no differences in pregnancy outcomes from euploid frozen blastocyst transfers after OCP primed antagonist cycles compared to estradiol pretreatment. In fact, the use of OCP pretreatment was associated with increased oocyte yield, keeping in mind demographic differences with the OCP pretreatment group being younger with higher anti-Müllerian hormone and a higher prevalence of PCOS. Thus, OCP priming should still be considered in specific populations, such as those with oligo-ovulation or adequate ovarian reserve.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collecting semen samples at home for fertility assessment: time for a new standard?","authors":"Paola Scaruffi, Francesca Bovis, Claudia Massarotti, Elena Maccarini, Sara Stigliani, Caterina DE Leo, Irene Gazzo, Fausta Sozzi, Paola Anserini","doi":"10.23736/S2724-606X.23.05165-5","DOIUrl":"10.23736/S2724-606X.23.05165-5","url":null,"abstract":"<p><strong>Background: </strong>In fertility clinics the standard approach to semen collection involves a private room close to the laboratory to avoid fluctuations in temperature and to control the time between collection and processing. There are still no firm conclusions whether collecting semen at home has any influence on sperm quality and reproductive competence. The purpose of this study was to assess whether the site of semen collection affects semen parameters.</p><p><strong>Methods: </strong>This retrospective cohort study performed at a tertiary level public fertility center included 8634 semen samples from 5880 men undergoing fertility assessment from 2015 to 2021. The impact of sample collection site was evaluated using a generalized linear mixed model. A subgroup analysis comparing clinic to home collection within the same patient was performed on 1260 samples from 428 men by paired t-test or Wilcoxon Signed Rank Test.</p><p><strong>Results: </strong>Samples collected at home (N.=3240) had significantly higher semen volume, sperm concentration and total sperm count respect to samples collected at clinic (N.=5530) (median (range): 2.9 (0.0-13.9) mL versus 2.9 (0.0-11.5) mL, P=0.016; 24.0 (0.0-252.0) million/mL versus 18.0 (0.0-390.0), P<0.0001; 64.6 (0.0-946.0) million versus 49.3 (0.0-1045.0), P<0.0001, respectively). There was no difference in abstinence period and sperm motility. Paired comparisons of semen characteristics in 428 patients with home-collected (N.=583) and clinic-collected (N.=677) samples confirmed a no negative effect on volume and total sperm count.</p><p><strong>Conclusions: </strong>Our data provide evidence for a not disadvantage with collection at home.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9406833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role and effectiveness of progestins in pituitary suppression during ovarian stimulation for assisted reproductive technology: a systematic review and a meta-analysis.","authors":"Sule Yildiz, Engin Turkgeldi, Baris Ata","doi":"10.23736/S2724-606X.22.05176-4","DOIUrl":"10.23736/S2724-606X.22.05176-4","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the many unknowns about its exact mechanism, progesterone and progestins are being successfully used to prevent luteinizing hormone (LH) surge during ovarian stimulation for assisted reproductive technology (ART). We will review progestin primed ovarian stimulation (PPOS) protocols in comparison with gonadotropin releasing hormone (GnRH) analogues and each other.</p><p><strong>Evidence acquisition: </strong>MEDLINE via PubMed; Cochrane Central Register of Controlled Trials (CENTRAL); Scopus; Web of Science were screened with keywords related to assisted reproductive technology, ovarian stimulation progesterone, GnRH analogue and progesterone in several combinations. Search period was from the date of inception of each database until 20 May 2022.</p><p><strong>Evidence synthesis: </strong>Live birth or ongoing pregnancy rate per embryo transfer (ET) was similar in PPOS and GnRH antagonist cycles (RR=1.16, 95% CI: 0.93-1.44). Clinical pregnancy rate per ET was likewise similar (RR=1.12, 95% CI: 0.92-1.37). Miscarriage rate per pregnancy was similar with PPOS and GnRH antagonists in autologous cycles (RR=1.01, 95% CI: 0.65-1.55). Pooled analyses showed similar live birth rate between progestins and short GnRH agonist protocols (RR=1.01, 95% CI: 0.49-2.09), however, clinical pregnancy rates per ET were significantly higher with progestins (RR=1.31, 95% CI: 1.06-1.62). Miscarriage rate per pregnancy was similar with progestins (RR=0.82, 95% CI: 0.55-1.21).</p><p><strong>Conclusions: </strong>Progestins seem to be an efficient option for pituitary suppression during ovarian suppression, providing similar outcomes for stimulation and pregnancy. They can be especially beneficial for women for whom fresh ET is not considered.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33488069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}