Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled Study
Background: Progestin-primed ovarian stimulation (PPOS) using dydrogesterone (DYG) has emerged as a potential alternative to conventional gonadotropin-releasing hormone antagonist (GnRH-ant) protocols for controlled ovarian stimulation (COS) cycles. However, the efficacy of the DY...
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| Format: | Article |
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IMR Press
2025-04-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/52/4/10.31083/CEOG27951 |
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| author | Trong Thach Than Duc Thang Le Ha Ngoc Thien Thanh Nguyen Thi Ngoc Chau Duong Thai Thanh Khue Le Manh Ha Nguyen Hoang Le |
| author_facet | Trong Thach Than Duc Thang Le Ha Ngoc Thien Thanh Nguyen Thi Ngoc Chau Duong Thai Thanh Khue Le Manh Ha Nguyen Hoang Le |
| author_sort | Trong Thach Than |
| collection | DOAJ |
| description | Background: Progestin-primed ovarian stimulation (PPOS) using dydrogesterone (DYG) has emerged as a potential alternative to conventional gonadotropin-releasing hormone antagonist (GnRH-ant) protocols for controlled ovarian stimulation (COS) cycles. However, the efficacy of the DYG-based PPOS regimen has not been well established. This study aimed to assess the efficacy and safety of the DYG-based PPOS protocol compared to the conventional GnRH-ant regimen during the various stages of COS and intra-cytoplasmic sperm injection (ICSI) procedures. Methods: A randomized controlled trial (RCT) was conducted on 200 infertile women who underwent COS using either the GnRH-ant (n = 100) or PPOS (n = 100) protocols. Generalized linear regression analysis with the appropriate distribution was applied to estimate the adjusted effect of the PPOS protocol on oocyte maturation and retrieval, fertilization, and embryo formation. Results: Both treatment groups had comparable hormonal profiles and procedural characteristics. Compared to the GnRH-ant protocol, the PPOS protocol resulted in an average increase of 1.67 oocytes per retrieval (95% confidence interval (CI): 0.29; 3.04; p = 0.017). The PPOS protocol demonstrated a modest yet significant improvement in the likelihood of oocyte maturation, with an adjusted mean difference of 4.2% (95% CI: 0.4; 8.0; p = 0.03), corresponding to an odds ratio of 1.23 (95% CI: 1.02; 1.47; p = 0.03). The fertilization and embryo development rates (cleavage embryos and blastocysts) were similar between the two protocols. Conclusions: Our findings suggest that the PPOS protocol using DYG offers a slight yet significant advantage over the GnRH-ant protocol regarding the total number of retrieved oocytes and the maturation rate, while maintaining comparable fertilization rates and embryo development outcomes. Clinical Trial Registration: The study has been registered on https://classic.clinicaltrials.gov/ (registration number: NCT06191809). |
| format | Article |
| id | doaj-art-04f7385ae2274eec82f774032bbce33e |
| institution | OA Journals |
| issn | 0390-6663 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-04f7385ae2274eec82f774032bbce33e2025-08-20T02:19:34ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632025-04-015242795110.31083/CEOG27951S0390-6663(25)02574-6Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled StudyTrong Thach Than0Duc Thang Le1Ha Ngoc Thien Thanh Nguyen2Thi Ngoc Chau Duong3Thai Thanh Khue Le4Manh Ha Nguyen5Hoang Le6Department of Obstetrics and Gynecology, Hanoi Medical University, 100000 Ha Noi, VietnamDepartment of Assisted Reproduction, Tam Anh General Hospital, 100000 Ha Noi, VietnamDepartment of Assisted Reproduction, An Sinh Hospital, 700000 Ho Chi Minh City, VietnamDepartment of Obstetrics and Gynecology, University of Medicine and Pharmacy, 700000 Ho Chi Minh City, VietnamDepartment of Obstetrics and Gynecology, University of Medicine and Pharmacy, 700000 Ho Chi Minh City, VietnamDepartment of Obstetrics and Gynecology, Hanoi Medical University, 100000 Ha Noi, VietnamDepartment of Assisted Reproduction, Tam Anh General Hospital, 100000 Ha Noi, VietnamBackground: Progestin-primed ovarian stimulation (PPOS) using dydrogesterone (DYG) has emerged as a potential alternative to conventional gonadotropin-releasing hormone antagonist (GnRH-ant) protocols for controlled ovarian stimulation (COS) cycles. However, the efficacy of the DYG-based PPOS regimen has not been well established. This study aimed to assess the efficacy and safety of the DYG-based PPOS protocol compared to the conventional GnRH-ant regimen during the various stages of COS and intra-cytoplasmic sperm injection (ICSI) procedures. Methods: A randomized controlled trial (RCT) was conducted on 200 infertile women who underwent COS using either the GnRH-ant (n = 100) or PPOS (n = 100) protocols. Generalized linear regression analysis with the appropriate distribution was applied to estimate the adjusted effect of the PPOS protocol on oocyte maturation and retrieval, fertilization, and embryo formation. Results: Both treatment groups had comparable hormonal profiles and procedural characteristics. Compared to the GnRH-ant protocol, the PPOS protocol resulted in an average increase of 1.67 oocytes per retrieval (95% confidence interval (CI): 0.29; 3.04; p = 0.017). The PPOS protocol demonstrated a modest yet significant improvement in the likelihood of oocyte maturation, with an adjusted mean difference of 4.2% (95% CI: 0.4; 8.0; p = 0.03), corresponding to an odds ratio of 1.23 (95% CI: 1.02; 1.47; p = 0.03). The fertilization and embryo development rates (cleavage embryos and blastocysts) were similar between the two protocols. Conclusions: Our findings suggest that the PPOS protocol using DYG offers a slight yet significant advantage over the GnRH-ant protocol regarding the total number of retrieved oocytes and the maturation rate, while maintaining comparable fertilization rates and embryo development outcomes. Clinical Trial Registration: The study has been registered on https://classic.clinicaltrials.gov/ (registration number: NCT06191809).https://www.imrpress.com/journal/CEOG/52/4/10.31083/CEOG27951controlled ovarian stimulationgnrh antagonist protocolprogestin-primed ovarian stimulation (ppos) |
| spellingShingle | Trong Thach Than Duc Thang Le Ha Ngoc Thien Thanh Nguyen Thi Ngoc Chau Duong Thai Thanh Khue Le Manh Ha Nguyen Hoang Le Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled Study Clinical and Experimental Obstetrics & Gynecology controlled ovarian stimulation gnrh antagonist protocol progestin-primed ovarian stimulation (ppos) |
| title | Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled Study |
| title_full | Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled Study |
| title_fullStr | Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled Study |
| title_full_unstemmed | Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled Study |
| title_short | Progestin-Primed Ovarian Stimulation with Dydrogesterone Improves Oocyte and Embryo Outcomes in Women Undergoing In Vitro Fertilization: A Randomized Controlled Study |
| title_sort | progestin primed ovarian stimulation with dydrogesterone improves oocyte and embryo outcomes in women undergoing in vitro fertilization a randomized controlled study |
| topic | controlled ovarian stimulation gnrh antagonist protocol progestin-primed ovarian stimulation (ppos) |
| url | https://www.imrpress.com/journal/CEOG/52/4/10.31083/CEOG27951 |
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