Optimal Ovulation Trigger-Oocyte Pickup Interval in Progestin-Primed Ovarian Stimulation Protocol: A Retrospective...

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)

Background:

• Progestin-primed ovarian stimulation (PPOS) is a common protocol for controlled ovarian hyperstimulation.
• Determining the optimal interval between ovulation trigger and oocyte pickup (OPU) is crucial for maximizing IVF success rates.

Purpose of the Study:

• To identify the optimal ovulation trigger-oocyte pickup (OPU) interval for the PPOS protocol.
• To evaluate the impact of different trigger-OPU intervals on oocyte maturation, implantation, and live birth rates.

Main Methods:

• Retrospective cohort study of 7,258 patients undergoing their first PPOS OPU cycle (July 2013-April 2018).
• Part I analyzed trends in mature oocyte, implantation, and live birth rates across the entire trigger-OPU interval (33-39.5 h).
• Part II used propensity score matching to compare outcomes in trigger-OPU interval groups: 35.6-36.4 h, 36.4-37.1 h, and 37.1-37.8 h.

Main Results:

• The PPOS protocol showed a trend towards high mature oocyte rates (>80%), increasing implantation, and high live birth rates across the 33-39.5 h interval.
• After propensity score matching, intervals of 36.4-37.1 h and 37.1-37.8 h demonstrated significantly higher mature oocyte rates (84.54%, 84.60%) and implantation rates (34.17%, 34.37%) compared to the 35.6-36.4 h interval (82.34%, 29.61%).
• Similar trends favoring the longer intervals were observed for live birth rates.

Conclusions:

• An ovulation trigger-oocyte pickup (OPU) interval of 36.4-37.8 hours is optimal for patients undergoing the PPOS protocol.
• This specific interval is associated with improved key performance indicators in IVF, including oocyte maturation and implantation.
• Optimizing the trigger-OPU timing can enhance live birth rates in assisted reproductive technologies.