Comparison of Cumulative Live Birth Rates Between Progestin and GnRH Analogues in Preimplantation Genetic Testing...

Area of Science:

• Reproductive Endocrinology
• Assisted Reproductive Technologies

Background:

• Progestins are emerging as an alternative to GnRH analogues for preventing premature LH surge in vitrified embryo transfer cycles.
• Long-term data on progestin-primed ovarian stimulation (PPOS) efficacy, including oocyte competence and live birth rates (LBR), are limited.

Purpose of the Study:

• To compare the cumulative LBR in preimplantation genetic testing (PGT) cycles between PPOS and GnRH analogue regimens.
• To evaluate secondary outcomes such as time to LBR, pregnancy rates, and perinatal outcomes.

Main Methods:

• Retrospective cohort study involving 967 patients with good prognosis undergoing PGT cycles.
• Patients were divided into three groups: GnRH agonist, GnRH antagonist, and PPOS regimen (using medroxyprogesterone 17-acetate).
• Primary outcome was cumulative LBR; secondary outcomes included pregnancy and perinatal data.

Main Results:

• PPOS regimen was associated with significantly lower cumulative LBR compared to both GnRH antagonist and agonist groups (28.4% vs 40.7% and 42.7%).
• The PPOS group had reduced cumulative pregnancy rates and a lower number/ratio of good-quality blastocysts.
• Time to live birth was longer with PPOS compared to GnRH antagonists; perinatal outcomes were comparable.

Conclusions:

• The PPOS regimen may negatively impact cumulative LBR and blastocyst quality in PGT cycles for women with good prognosis.
• GnRH analogues appear more effective in achieving live births and preserving embryo quality in this context.