Daniela Paes de Almeida Ferreira Braga D.V.M., Ph.D. , Amanda Setti M.Sc. , Edward Carrilho M.D. , Patrícia Guilherme M.Sc. , Assumpto Iaconelli Jr. M.D. , Edson Borges Jr. M.D., Ph.D.
{"title":"以孕酮为前体的周期会导致胚胎发育较慢，但不会影响植入潜力，而且具有口服给药和潜在成本降低的优势","authors":"Daniela Paes de Almeida Ferreira Braga D.V.M., Ph.D. , Amanda Setti M.Sc. , Edward Carrilho M.D. , Patrícia Guilherme M.Sc. , Assumpto Iaconelli Jr. M.D. , Edson Borges Jr. M.D., Ph.D.","doi":"10.1016/j.xfss.2023.12.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To study the impact of the use of progesterone on embryo morphokinetics and on the outcomes of intracytoplasmic sperm injection cycles.</p></div><div><h3>Design</h3><p>Cohort study.</p></div><div><h3>Setting</h3><p>Private university–affiliated in vitro fertilization center.</p></div><div><h3>Patient(s)</h3><p>This study included 236 freeze-all intracytoplasmic sperm injection cycles and the resultant 2,768 injected oocytes cultured in a time-lapse imaging incubation system. Patients were matched by age and divided into groups depending on the protocol used to prevent the luteinizing hormone surge: progestin-primed (144 cycles and 1,360 embryos) and gonadotropin hormone-releasing hormone (GnRH) antagonist (144 cycles and 1,408 embryos) groups.</p></div><div><h3>Intervention(s)</h3><p>The kinetic recorded markers were time to pronuclear appearance and fading, time to 2–8 cells, time to morulation, time to start of blastulation, and time to blastulation. The durations of cell cycles and time to complete synchronous divisions were calculated. The Known Implantation Data Score ranking was recorded. Morphokinetics and clinical outcomes were compared between the groups.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Embryo morphokinetics and clinical outcomes.</p></div><div><h3>Results</h3><p>Slower time to pronuclear appearance, time to 2 cells, time to 7 cells, time to start of blastulation, and time to blastulation were observed in embryos derived from progestin-primed cycles than in those from the GnRH antagonist group. No significant differences were noted in any other morphokinetic milestone. Significantly higher cancellation and implantation rates were observed in the progestin-primed group. However, no significant differences were noted in the pregnancy and miscarriage rates. The expenses for treatment using premature GnRH antagonist and progestins were US$318.18 and US$11.05, respectively.</p></div><div><h3>Conclusions</h3><p>Exogenous progesterone replaces the GnRH antagonist for the prevention of premature luteinizing hormone surge, in freeze-all cycles, with the advantage of oral administration and potential cost reduction.</p></div>","PeriodicalId":73012,"journal":{"name":"F&S science","volume":"5 1","pages":"Pages 43-49"},"PeriodicalIF":0.0000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Progesterone-primed cycles result in slower embryos without compromising implantation potential and with the advantages of oral administration and potential cost reduction\",\"authors\":\"Daniela Paes de Almeida Ferreira Braga D.V.M., Ph.D. , Amanda Setti M.Sc. , Edward Carrilho M.D. , Patrícia Guilherme M.Sc. , Assumpto Iaconelli Jr. M.D. , Edson Borges Jr. M.D., Ph.D.\",\"doi\":\"10.1016/j.xfss.2023.12.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To study the impact of the use of progesterone on embryo morphokinetics and on the outcomes of intracytoplasmic sperm injection cycles.</p></div><div><h3>Design</h3><p>Cohort study.</p></div><div><h3>Setting</h3><p>Private university–affiliated in vitro fertilization center.</p></div><div><h3>Patient(s)</h3><p>This study included 236 freeze-all intracytoplasmic sperm injection cycles and the resultant 2,768 injected oocytes cultured in a time-lapse imaging incubation system. Patients were matched by age and divided into groups depending on the protocol used to prevent the luteinizing hormone surge: progestin-primed (144 cycles and 1,360 embryos) and gonadotropin hormone-releasing hormone (GnRH) antagonist (144 cycles and 1,408 embryos) groups.</p></div><div><h3>Intervention(s)</h3><p>The kinetic recorded markers were time to pronuclear appearance and fading, time to 2–8 cells, time to morulation, time to start of blastulation, and time to blastulation. The durations of cell cycles and time to complete synchronous divisions were calculated. The Known Implantation Data Score ranking was recorded. Morphokinetics and clinical outcomes were compared between the groups.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Embryo morphokinetics and clinical outcomes.</p></div><div><h3>Results</h3><p>Slower time to pronuclear appearance, time to 2 cells, time to 7 cells, time to start of blastulation, and time to blastulation were observed in embryos derived from progestin-primed cycles than in those from the GnRH antagonist group. No significant differences were noted in any other morphokinetic milestone. Significantly higher cancellation and implantation rates were observed in the progestin-primed group. However, no significant differences were noted in the pregnancy and miscarriage rates. The expenses for treatment using premature GnRH antagonist and progestins were US$318.18 and US$11.05, respectively.</p></div><div><h3>Conclusions</h3><p>Exogenous progesterone replaces the GnRH antagonist for the prevention of premature luteinizing hormone surge, in freeze-all cycles, with the advantage of oral administration and potential cost reduction.</p></div>\",\"PeriodicalId\":73012,\"journal\":{\"name\":\"F&S science\",\"volume\":\"5 1\",\"pages\":\"Pages 43-49\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"F&S science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666335X23000721\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"F&S science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666335X23000721","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Progesterone-primed cycles result in slower embryos without compromising implantation potential and with the advantages of oral administration and potential cost reduction
Objective
To study the impact of the use of progesterone on embryo morphokinetics and on the outcomes of intracytoplasmic sperm injection cycles.
Design
Cohort study.
Setting
Private university–affiliated in vitro fertilization center.
Patient(s)
This study included 236 freeze-all intracytoplasmic sperm injection cycles and the resultant 2,768 injected oocytes cultured in a time-lapse imaging incubation system. Patients were matched by age and divided into groups depending on the protocol used to prevent the luteinizing hormone surge: progestin-primed (144 cycles and 1,360 embryos) and gonadotropin hormone-releasing hormone (GnRH) antagonist (144 cycles and 1,408 embryos) groups.
Intervention(s)
The kinetic recorded markers were time to pronuclear appearance and fading, time to 2–8 cells, time to morulation, time to start of blastulation, and time to blastulation. The durations of cell cycles and time to complete synchronous divisions were calculated. The Known Implantation Data Score ranking was recorded. Morphokinetics and clinical outcomes were compared between the groups.
Main Outcome Measure(s)
Embryo morphokinetics and clinical outcomes.
Results
Slower time to pronuclear appearance, time to 2 cells, time to 7 cells, time to start of blastulation, and time to blastulation were observed in embryos derived from progestin-primed cycles than in those from the GnRH antagonist group. No significant differences were noted in any other morphokinetic milestone. Significantly higher cancellation and implantation rates were observed in the progestin-primed group. However, no significant differences were noted in the pregnancy and miscarriage rates. The expenses for treatment using premature GnRH antagonist and progestins were US$318.18 and US$11.05, respectively.
Conclusions
Exogenous progesterone replaces the GnRH antagonist for the prevention of premature luteinizing hormone surge, in freeze-all cycles, with the advantage of oral administration and potential cost reduction.
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