高孕激素状态下促排卵方案中不同孕激素对卵巢储备功能减退患者的应用效果比较OACSTPCD

Objective:To investigate the difference in ovulation induction effects and laboratory outcomes between medroxyprogesterone acetate(MPA)and dydrogesterone(DYG)in progestin primed ovarian stimulation(PPOS)protocol in patients with diminished ovarian reserve(DOR). Methods:A retrospective study was used to collect clinical data of patients with DOR who received PPOS protocol for IVF/ICSI assisted pregnancy at the Assisted Reproduction Center of Yuncheng Central Hospital from January 2022 to May 2023.A total of 299 cycles were included.The patients were divided into medroxyprogesterone acetate(MPA)group(177 cycles)and dydrogesterone(DYG)group(122 cycles)according to different types of progestin preparations used.The general data,ovulation induction effects and laboratory outcomes of the two groups were compared. Results:There were no significant differences in maternal age,BMI,infertility years,basic antral follicles count(AFC),basal serum levels of FSH,LH and E2,percentage of ICSI cycle,cycle number,duration and total dosage of HMG used,serum LH level on HCG day,number of oocytes retrieved,mature oocytes rate,normal fertilization rate,number of available embryos and high-quality embryos between the two groups(P＞0.05).The incidence of early LH peak(1.12％vs.6.55％),the levels of E2(5 732.98 pmol/L vs.6 758.45 pmol/L)and progesterone(1.97 nmol/L vs.2.07 nmol/L)on HCG day and progesterone cost(9 RMB vs.90 RMB)in MPA group were significantly lower than those in DYG group(P＜0.05). Conclusions:The use of MPA and DYG in PPOS protocol can achieve good laboratory outcomes for patients with DOR.However,MPA is more effective in controlling early LH peak,and it may be the preferred progestin for DOR patients.