Ovarian response in oocyte donation cycles under LH suppression with GnRH antagonist or desogestrel progestin: retrospective and comparative study

Abstract

Here are investigated the serum hormones in ovarian stimulation cycles of oocyte donors (OD), under endogenous luteinizing hormone (LH) suppression with GnRH antagonist (antGnRH) vs. desogestrel (DSG) (progesterone-primed [PP]). OD underwent ovarian stimulation with gonadotropins at a private, university-based, infertility center between January 2017 and March 2018. Endogenous LH peak was controlled with either daily injections of antGnRH or with daily oral 75 mcg DSG (PP) until triggering. LH and progesterone were measured at trigger and the following day. A total of 404 OD cycles were included. There were no differences in age (26.7 ± 4.9 vs. 27.1 ± 4.8 years), AMH (3.7 ± 2.1 vs. 4.1 ± 2.7 ng/ml), and body mass index (BMI) (22.4 ± 2.8 vs. 22.1 ± 3.0 kg/m²) between PP and antGnRH groups, respectively. On the day of trigger, progesterone was lower in PP compared to antGnRH (0.9 ± 0.7, vs. 1.5 ± 1.2 ng/ml, p < .001), whereas no significant differences existed in estradiol or LH. On the day after trigger, lower progesterone in PP vs. antGnRH (10.8 ± 6.0 vs. 13.4 ± 7.9 ng/ml, p=.002) was observed. No differences were observed in the number of retrieved oocytes or the clinical pregnancies among recipients. Our study shows that endocrine response to DSG differs significantly as compared to antGnRH use for the control of endogenous LH without apparent impact on number of retrieved oocytes or the clinical pregnancies among recipients.

摘要

本文旨在探讨GnRH拮抗剂（antGnRH）与去氧孕烯（DSG）（孕酮前体[PP]）抑制内源性黄体生成素（LH）在卵母细胞供体（OD）的卵巢刺激周期中血清激素的水平。2017年1月至2018年3月, 在一家私立大学的不孕症中心, OD接受了促性腺激素的刺激。内源性黄体生成素峰值通过每日注射GnRH拮抗剂（antGnRH）或每日口服75 mcg DSG（PP）来控制, 直至扳机日。扳机日和第二天测定LH和孕酮。总共纳入了404次OD刺激周期。两组患者的年龄（26.7 ± 4.9 vs.27.1± 4.8岁）, AMH（3.7 ± 2.1 vs.4.1± 2.7 ng/ml）以及体重指数（BMI）（22.4 ± 2.8 vs. 22.1 ± 3.0 kg/m²）之间无显著差异。扳机日, PP组的孕酮较antGnRH组低（0.9 ± 0.7, vs.1.5 ± 1.2 ng/ml, P<0.001）, 而雌二醇或LH两组间无显著差异。扳机后第2日, PP组的孕酮较antGnRH组低（10.8 ± 6.0 vs. 13.4 ± 7.9 ng/ml, p=0.002）。受试者的获卵数和临床妊娠数两组间无显著差异。我们的研究表明, 与antGnRH组对于内源性LH的抑制作用相比, DSG组对于内分泌的反应有显著差异, 但对获卵数或临床妊娠无明显影响。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Ovarian response
• oocyte donation
• GnRH antagonist
• desogestrel
• progesterone primed

Disclosure statement

No potential conflict of interest was reported by the authors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This research was performed under the auspices of ‘Catedra d’Investigacio en Obstetrıcia I Ginecologia’ of the Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital Universitario Dexeus, Universitat Autonoma de Barcelona.