Kedar Ganla¹, Rana Choudhary²*, Priyanka Vora², Seema Pandey³, Jayant Kamat⁴, Cyriac Pappachan⁵ and Anil Chittake⁶

¹Consultant, Department of Reproductive Medicine, Ankoor Fertility Clinic, Mumbai, India
²Associate Consultant, Department of Reproductive Medicine, Ankoor Fertility Clinic, Mumbai, India
³Consultant, Department of Reproductive Medicine, Seema IVF, UP, India
⁴Consultant, Department of Reproductive Medicine, Kamath Fertility clinic, Goa, India
⁵Consultant, Department of Reproductive Medicine, Life Line Hospital, Kerala, India
⁶Consultant, Department of Reproductive Medicine, Embrion IVF, Pune, India

*Corresponding Author: Dr Rana Choudhary, Associate Consultant, Department of Reproductive Medicine, Ankoor Fertility Clinic, Mumbai, India.

Received: September 01, 2022; Published: October 12, 2022

Abstract

Background: With advancement in IVF technology and vitrification, use of progesterone and its derivatives to block the LH surge is increasing. This was a prospective randomized controlled trial, in a private reproductive medicine clinic to compare the efficacy of preventing LH surges by using progesterone primed ovarian stimulation (PPOS) against gonadotropin-releasing hormone (GnRH) antagonist, in women with good ovarian reserve undergoing in vitro fertilization (IVF).

Method/Design: Study participants (n = 220) who met the inclusion criteria were randomized. Both group participants received hMG from day 2. Group 1 (hMG + DYG) received 10mg tablet Dydrogesterone, thrice a day, from day 2 of stimulation. Group 2 (hMG + GAN) received 0.25 mg of Ganirelix acetate, given subcutaneously from fifth day of stimulation till the day of trigger. Main Outcome Measure(s): The primary outcome measured was the incidence of premature LH surges. All embryos were frozen and transferred in the subsequent cycle. Participants were monitored by serial hormonal assays.

Main Outcome Measure(s): The primary point of measurement was the incidence of premature LH surges. We also studied the number of oocytes retrieved, number of embryos formed, implantation and clinical pregnancy rate along with the additional cost per cycle as our secondary end parameters.

Result (s): All subjects in both groups had well controlled LH levels suggesting good control over prevention of premature leutinisation. There was no significant difference in the number (mean ± SD) of oocytes retrieved [P = 0.0691] and viable embryos or the pregnancy rate (PR) after FET 48% {43.64, median (IQR)} versus 39% {(35.45, median (IQR)} (P = 0.215). The additional cost per cycle was significantly high in the antagonist group (p < 0.001).

Conclusion: Our results suggest that Dydrogesterone effectively inhibited spontaneous ovulation, without affecting the number of retrieved oocytes, embryo quality, implantation and pregnancy rates (PR). The cost difference and patient acceptance between both the groups was significant with Dydrogesterone allowing lower costs and easier (oral) administration thus making IVF cycle more patient friendly.

Keywords: LH Surge; Dydrogesterone; Ganirelix Acetate; GnRh Antagonist; PPOS; Freeze All

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Citation

Citation: Rana Choudhary., et al. “A Prospective Comparative Interventional Study of Dydrogesterone (Progestin Primed Ovarian Stimulation) Versus Ganirelix Acetate (GnRh Anatgonist) for Freeze-all IVF/ICSI Cycles". Acta Scientific Women's Health 4.11 (2022): 06-18.

Copyright

Copyright: © 2022 Rana Choudhary., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.