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Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization
A major cause of cycle cancellation during controlled ovarian hyperstimulation (COH) in women undergoing in vitro fertilization (IVF) is the occurrence of premature luteinizing hormone (LH) surges. Steroidal preparations can modulate the secretion of gonadotropins (Gn); however, few studies using pr...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Wolters Kluwer Health
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616424/ https://www.ncbi.nlm.nih.gov/pubmed/26020402 http://dx.doi.org/10.1097/MD.0000000000000909 |
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author | Zhu, Xiuxian Zhang, Xiaole Fu, Yonglun |
author_facet | Zhu, Xiuxian Zhang, Xiaole Fu, Yonglun |
author_sort | Zhu, Xiuxian |
collection | PubMed |
description | A major cause of cycle cancellation during controlled ovarian hyperstimulation (COH) in women undergoing in vitro fertilization (IVF) is the occurrence of premature luteinizing hormone (LH) surges. Steroidal preparations can modulate the secretion of gonadotropins (Gn); however, few studies using progesterone to inhibit the premature LH surges in COH have been published. The purpose of the study was to evaluate the oral delivery of progesterone soft capsules (Utrogestan) to prevent LH surges from the follicular phase and to compare cycle characteristics as well as to evaluate pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles. A total of 374 patients were enrolled in this retrospective study, among which 187 patients were simultaneously administered Utrogestan and human menopausal gonadotrophin (hMG) from cycle day 3 until the trigger day. A short protocol including 187 controls with comparable age, body mass index (BMI), infertility duration, and antral follicle count was also used. GnRH agonist (0.1 mg) or hCG (3000 IU) was used for a trigger when the dominant follicles matured. Viable embryos were cryopreserved for later transfer in both groups. The primary outcome was the number of oocytes retrieved. The secondary outcomes included the number of mature oocytes, incidence of premature LH surge, and clinical pregnancy outcomes from FET cycles. Consistent LH suppression was achieved during COH, with a range of 0.07 to 8.9 IU/L, and no premature LH surge was detected. The number of oocytes retrieved in the Utrogestan and hMG protocol was comparable with that in the short protocol (10.92 ± 5.74 vs 10.6 ± 6.22, P > 0.05), and the dose of hMG was higher than that used in the short protocol (1884.22 ± 439.47 IU vs 1446.26 ± 550.48 IU, P < 0.05). No significant between-group difference was observed in the mature oocyte rate (88.88% vs 90.12%), cleavage rate (96.58% vs 96.58%), clinical pregnancy rate (54.27% vs 51.65%), or implantation rate (33.59% vs 34.02%). The study shows that Utrogestan is an effective oral alternative for preventing premature LH surges in women undergoing COH, which will help to establish a convenient user regimen in combination with FET. |
format | Online Article Text |
id | pubmed-4616424 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-46164242015-10-27 Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization Zhu, Xiuxian Zhang, Xiaole Fu, Yonglun Medicine (Baltimore) 5600 A major cause of cycle cancellation during controlled ovarian hyperstimulation (COH) in women undergoing in vitro fertilization (IVF) is the occurrence of premature luteinizing hormone (LH) surges. Steroidal preparations can modulate the secretion of gonadotropins (Gn); however, few studies using progesterone to inhibit the premature LH surges in COH have been published. The purpose of the study was to evaluate the oral delivery of progesterone soft capsules (Utrogestan) to prevent LH surges from the follicular phase and to compare cycle characteristics as well as to evaluate pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles. A total of 374 patients were enrolled in this retrospective study, among which 187 patients were simultaneously administered Utrogestan and human menopausal gonadotrophin (hMG) from cycle day 3 until the trigger day. A short protocol including 187 controls with comparable age, body mass index (BMI), infertility duration, and antral follicle count was also used. GnRH agonist (0.1 mg) or hCG (3000 IU) was used for a trigger when the dominant follicles matured. Viable embryos were cryopreserved for later transfer in both groups. The primary outcome was the number of oocytes retrieved. The secondary outcomes included the number of mature oocytes, incidence of premature LH surge, and clinical pregnancy outcomes from FET cycles. Consistent LH suppression was achieved during COH, with a range of 0.07 to 8.9 IU/L, and no premature LH surge was detected. The number of oocytes retrieved in the Utrogestan and hMG protocol was comparable with that in the short protocol (10.92 ± 5.74 vs 10.6 ± 6.22, P > 0.05), and the dose of hMG was higher than that used in the short protocol (1884.22 ± 439.47 IU vs 1446.26 ± 550.48 IU, P < 0.05). No significant between-group difference was observed in the mature oocyte rate (88.88% vs 90.12%), cleavage rate (96.58% vs 96.58%), clinical pregnancy rate (54.27% vs 51.65%), or implantation rate (33.59% vs 34.02%). The study shows that Utrogestan is an effective oral alternative for preventing premature LH surges in women undergoing COH, which will help to establish a convenient user regimen in combination with FET. Wolters Kluwer Health 2015-05-29 /pmc/articles/PMC4616424/ /pubmed/26020402 http://dx.doi.org/10.1097/MD.0000000000000909 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 5600 Zhu, Xiuxian Zhang, Xiaole Fu, Yonglun Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization |
title | Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization |
title_full | Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization |
title_fullStr | Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization |
title_full_unstemmed | Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization |
title_short | Utrogestan as an Effective Oral Alternative for Preventing Premature Luteinizing Hormone Surges in Women Undergoing Controlled Ovarian Hyperstimulation for In Vitro Fertilization |
title_sort | utrogestan as an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization |
topic | 5600 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616424/ https://www.ncbi.nlm.nih.gov/pubmed/26020402 http://dx.doi.org/10.1097/MD.0000000000000909 |
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