Linking back-to-back stimulation cycles with oral contraceptives or progestins in women undergoing embryo accumulation for preimplantation genetic testing, a retrospective study

Abstract

This retrospective study was carried out to determine which strategy is associated with improved outcomes in two back-to-back cycles when undergoing embryo accumulation. Eighty patients with two stimulation cycles performed with <45 days between retrievals between Jan’16-Mar’17 were included. Patients were segregated according to the strategy used to link stimulations: spontaneous menses (SM), vaginal micronized progesterone (VMP) or oral contraceptive pills (OCP). Main outcome measure was oocytes retrieved. The oocytes retrieved difference between cycles was −0.9 in SM, −1.5 in VMP and +0.4 in OCPs. Although not statistically significant, more oocytes retrieved were observed in the 2ndcycle when OCPs were used (9.0 ± 3.7 vs. 9.4 ± 4.1)? whereas fewer oocytes retrieved were observed when SM (9.4 ± 3.9 vs. 8.5 ± .0) or VMP (9.8 ± 5.7 vs. 8.2 ± 4.4) were used. After adjusting for age, gonadotropins and stimulation days (2nd cycle) and treatment group in an ANCOVA model, no treatment was associated with a higher average number of oocytes retrieved (power: 14.9%) or a higher difference of oocytes retrieved (power: 22.3%). Although no statistical significance was reached, OCPs were observed to achieve higher average and positive difference of oocytes retrieved in the 2nd cycle.

摘要

本项回顾性研究旨在确定在接受胚胎积累女性的两个连续刺激周期中, 哪种策略与改善结局相关。经检索在1月16日至3月17日之间进行两次＜45天刺激周期的患者共有80例。根据不同刺激策略对患者进行以下分组：自发性月经（spontaneous menses, SM）、阴道微粒化黄体酮（vaginal micronized progesterone, VMP）和口服避孕药（oral contraceptive pills, OCP）。主要观察指标为获卵数。周期间获卵数的差异在SM组为-0.9, VMP组为-1.5, OCPs组为+0.4。尽管没有统计学意义, 但OCPs组在第2周期中可观察到更多的获卵数（9.0±3.7和9.4±4.1）；相反, SM组（9.4±3.9和8.5±.0）和VMP组（9.8±5.7和8.2±4.4）则观察到相对较少的获卵数。在协方差分析模型中, 调整年龄、促性腺激素及刺激天数（第2周期）和治疗组后, 未发现不同治疗与高平均获卵数（power：14.9%）或获卵数存在明显差异（power：22.3%）相关。尽管未达到统计学意义, 但观察到OCPs组在第2周期中平均获卵数和阳性差异更高。

Keywords:

• Ovarian stimulation
• embryo accumulation
• preimplantation genetic testing
• linking IVF
• preimplantation genetic screening

Disclosure statement

No potential conflict of interest was reported by the authors.