Oocyte competence is comparable between progestin primed ovarian stimulation with Norethisterone acetate (NETA-PPOS) and GnRH-antagonist protocols: A matched case-control study in PGT-A cycles

•Oocyte competence after NETA-PPOS and GnRH-antagonist protocol is comparable.•PPOS might be an effective, user-friendly and inexpensive alternative to standard protocols.•PPOS protocol can be considered whenever a freeze-all strategy is indicated. To outline oocyte competence after progestin primed...

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Veröffentlicht in:European journal of obstetrics & gynecology and reproductive biology 2024-03, Vol.294, p.4-10
Hauptverfasser: Vaiarelli, Alberto, Cimadomo, Danilo, Ruffa, Alessandro, Rania, Erika, Pittana, Erika, Gallo, Cinzia, Fiorenza, Alessia, Alviggi, Erminia, Alfano, Simona, Carmelo, Ramona, Trabucco, Elisabetta, Alviggi, Carlo, Rosaria Campitiello, Maria, Rienzi, Laura, Maria Ubaldi, Filippo, Venturella, Roberta
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Sprache:eng
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Zusammenfassung:•Oocyte competence after NETA-PPOS and GnRH-antagonist protocol is comparable.•PPOS might be an effective, user-friendly and inexpensive alternative to standard protocols.•PPOS protocol can be considered whenever a freeze-all strategy is indicated. To outline oocyte competence after progestin primed ovarian stimulation with Norethisterone acetate (NETA-PPOS) compared to conventional GnRH-antagonist protocol. Retrospective matched case-control study involving advanced-maternal-age women undergoing ICSI with PGT-A. 89 NETA-PPOS were matched with 178 control patients based on maternal age and ovarian reserve biomarkers. Both groups underwent recombinant-FSH OS with GnRH-agonist ovulation trigger and collected ≥1 MII. In the study group, NETA (10 mg/day) was administered orally starting from day2 of the menstrual cycle. Euploid blastocyst rate per cohort of metaphase-II oocytes (EBR per MII) was the primary outcome. All other embryological and clinical outcomes were reported. Gestational age, birthweight and length were also assessed. The EBR per MII was comparable among PPOS and control (13.9 % ± 19.3 % versus 13.3 % ± 17.9 %; the sample size allowed to exclude up to a 10 % difference). Blastocysts morphology and developmental rate were similar. No difference was reported for all clinical outcomes among the 61 and 107 vitrified-warmed euploid single blastocyst transfers respectively conducted. The cumulative live birth delivery rate per concluded cycles was also comparable (24.7 % versus 21.9 %). Neonatal outcomes were analogous. Oocyte competence after NETA-PPOS and standard OS is comparable. This evidence is reassuring and, because of its lower cost and possibly higher patients’ compliance, supports PPOS administration whenever the patients are indicated to freeze-all (e.g., fertility preservation, PGT-A, oocyte donation). More data are required about follicle recruitment, oocyte yield, gestational and perinatal outcomes. Randomized-controlled-trials are advisable to confirm our evidence.
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2023.12.035