Duphaston for preventing premature luteinizing hormone surges in women with polycystic ovarian syndrome undergoing controlled ovarian hyper stimulation: A randomized clinical trial

Background: Polycystic ovarian syndrome, is considered a prevalent endocrine disorder. IVF (in vitro fertilization) is the major therapy. The use of new ways of improving clinical results is yet promptly required. It has been proved that progesterone (P) prevents pulsatile LH and GnRH secretion seriously and inhibits the E2-caused effects of the positive feedback throughout the luteal stage via reducing the frequency of the GnRH pulse.Objective: An RCT was devised to assess the cycle features and endocrinological characteristics of individuals using gonadotrophin accompanied by receiving dydrogesterone co-treatment, and to compare pregnancy results in FET (first frozen embryo transfer) cycles with the antagonist-GnRh protocol considered as the control.Materials and Methods: A total of 120 individuals with PCOS, who volunteered for ART, got included in the research. The patients were classified into two groups. In PPOS group the patents received 20 mg dydrogesterone orally since the second day of the cycle. All patients in controlled group received Antagonist protocol.Results: From total 120 patients who had including criteria, 60 people were selected for each group randomly. No. of MII oocyte, maturity rate, No. of 2 pronuclei (2PN) and serum E2 levels on trigger day were lower in PPOS group (p<0.05). Serum LH level on trigger day in PPOS group was higher than antagonist group (5.29 vs 3.79; p<0.05).Although there wasn’t sever OHSS in any patient, mild and moderate OHSS was less in PPOS group (36.5% vs. 68.3%; p<0.05). Chemical and clinical pregnancy were more in antagonist group, but it was not statistically significant (p> 0.05).Conclusion: Our study fails to demonstrate that PPOS has the potential to improve chemical and clinical pregnancy rate of the infertile women with PCOS.

Keywords:

Progesterone , Polycystic ovarian syndrome , Controlled ovarian stimulation , Frozen thawed embryo transfer , Pregnancy rate.