Evaluation of pregnancy outcomes using medroxyprogesterone acetate versus gonadotropin-releasing hormone antagonist in ovarian stimulation: A retrospective cohort study

Publish Year: 1401
نوع سند: مقاله ژورنالی
زبان: English
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JR_IJRM-20-6_007

تاریخ نمایه سازی: 4 مرداد 1401

Abstract:

Background: Limited studies have compared pregnancy outcomes with medroxyprogesterone acetate (MPA) vs. gonadotropin-releasing hormone antagonist (GnRH antagonist) in ovarian stimulation protocols. The results show heterogeneity. Objective: This study aims to assess pregnancy outcomes with the use of MPA instead of GnRH antagonist for ovarian stimulation in donor-recipient cycles. Materials and Methods: This retrospective study was carried out from June ۲۰۱۶ to May ۲۰۱۹. The study included ۲۵۰ donors receiving ovarian stimulation with ۲ different protocols: group ۱ (n = ۱۰۹) receiving GnRH antagonist (۰.۲۵ mg/day) from the ۵th or ۶th  day of menses and group ۲ (n = ۱۴۱) receiving MPA (۱۰ mg/day) from the second day of menses. In ۳۸۴ recipients, ۲ good-quality blastocysts were transferred after endometrial preparation. The primary endpoint was live birth in recipients. Results: The results showed that live birth was comparable in both recipient groups (۵۹% vs. ۶۰%, OR: ۰.۶۳, ۹۵% CI: ۰.۱۳-۲.۹۹, p = ۰.۵۵۹). The number of live-born fetuses (adjusted OR: ۰.۵۷, ۹۵% CI: ۰.۳۱-۱.۰۵, p > ۰.۰۱) showed no significant difference in both groups. However, the implantation rate with twin sacs was significantly lower in group ۲ (adjusted OR: ۰.۵۷, ۹۵% CI: ۰.۳۳-۰.۹۹, p = ۰.۰۵). The regression analysis for goodquality blastocyst proportion was comparable (OR: ۰.۶۳, ۹۵% CI: -۴.۳۳-۵.۶۰, p = ۰.۸۰۲) in both donor groups. The mean stimulation cost in group ۲ was less than in group ۱. Conclusion: MPA had a comparable live birth and embryological outcomes in both groups. Oral administration makes it convenient, acceptable, and patient-friendly. Its cost-effectiveness and convenience open new possibilities in ovarian stimulation protocols.

Authors

Ekika Singh

Sharda Narayan Hospital, Mau, UP, India.

Christophe Blockeel

Centre for Reproductive Medicine, Laarbeeklaan, Brussels, Belgium.

Madhulika Singh

Sharda Narayan Hospital, Mau, UP, India.

Rishi Gupta

Manokalp Clinic, Delhi, India.

Sandesh Kamdi

Pacific Academy of Higher Education and Research University, Udaipur, Rajasthan, India.

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