Comparison of dydrogesterone and medroxyprogesterone acetate in progestin-primed ovarian stimulation protocol for patients with poor ovarian response: a propensity score matching cohort study
10.3760/cma.j.cn101441-20220304-00096
- VernacularTitle:卵巢低反应人群应用高孕酮状态下促排卵方案中地屈孕酮和醋酸甲羟孕酮的对比：一项倾向性评分匹配队列研究
- Author:
Mingze DU
1
;
Junwei ZHANG
1
;
Xiaona YU
1
;
Zhen LI
1
;
Yichun GUAN
1
Author Information
1. 郑州大学第三附属医院生殖医学科，郑州 450052
- Publication Type:Journal Article
- Keywords:
Dydrogesterone;
Medroxyprogesterone acetate;
Progestin-primed ovarian stimulation;
Clinical pregnancy rate
- From:
Chinese Journal of Reproduction and Contraception
2023;43(7):670-675
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical outcomes of dydrogesterone and medroxyprogesterone acetate (MPA) in the progestin-primed ovarian stimulation (PPOS) protocol for patients with poor ovarian response (POR).Methods:This study was a single-center retrospective cohort study. POR patients who underwent PPOS protocol in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2019 to September 2021 were included for analysis. According to different progestin drugs used, they were divided into dydrogesterone group and MPA group. Propensity score matching (PSM) was performed 1∶3 to correct for confounding factors. Outcome measures were the number of available embryos, oocytes retrieved, two pronuclei (2PN) and high-quality embryos, the clinical pregnancy rate and the continuing pregnancy rate in the first frozen embryo transfer cycle.Results:A total of 1 962 cycles were included, including 494 cycles in the dydrogesterone group and 1 468 cycles in the MPA group. There was a statistically significant difference in infertility factors between the two groups ( P=0.045). The other baseline characteristics were not significantly different (all P>0.05). The initiating dosage of gonadotropin (Gn) in the dydrogesterone group [300 (225, 300) U] was lower than that in the MPA group [300 (300, 300) U, P<0.001]. There were no significant differences in the duration and total dosage of Gn used, premature luteinizing hormone surge rate, the number of oocytes retrieved, the number of 2PN, the number of available embryos and the number of good-quality embryos between the two groups (all P>0.05). A total of 1 331 cycles underwent the first frozen-thawed embryo transfer, including 268 cycles in the dydrogesterone group and 1 063 cycles in the MPA group. There were no significant differences in endometrial thickness on the day of embryo transfer, the number of transferred embryos, the stage of transferred embryos, and the endometrial preparation protocols between the two groups (all P>0.05). There were no significant differences in the clinical pregnancy rate and the ongoing pregnancy rate between the two groups ( P=0.832, P=0.798). Conclusion:For POR patients, similar clinical outcomes were obtained with dydrogesterone and MPA in the PPOS protocol, suggesting that dydrogesterone can be an effective alternative to the PPOS protocol.
