title: Medroxyprogesterone acetate is an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization.
abstract: OBJECTIVE
  To investigate the use of medroxyprogesterone acetate (MPA) to prevent LH surge during controlled ovarian hyperstimulation (COH) and to compare cycle characteristics and pregnancy outcomes in subsequently frozen-thawed ET (FET) cycles.
  
  
  METHODS
  A prospective controlled study.
  
  
  METHODS
  Tertiary-care academic medical center.
  
  
  METHODS
  Three hundred patients undergoing IVF/intracytoplasmic sperm injection treatment.
  
  
  METHODS
  In the study group, hMG and MPA were administered simultaneously beginning on cycle day 3. Ovulation was induced with a GnRH agonist or cotriggered by a GnRH agonist and hCG when dominant follicles matured. A short protocol was used in the control group. Viable embryos were cryopreserved for later transfer in both protocols.
  
  
  METHODS
  The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the number of mature oocytes, the incidence of premature LH surge, and clinical pregnancy outcomes from FETs.
  
  
  RESULTS
  The number of oocytes retrieved in the study group was similar to those in the controls (9.9 ± 6.7 vs. 9.0 ± 6.0), and higher doses of hMG were administered. In the study group, LH suppression persisted during ovarian stimulation, and the incidence of premature LH surge was 0.7% (1/150). No statistically significant differences were found in the clinical pregnancy rates (47.8% vs. 43.3%), implantation rates (31.9% vs. 27.7%), and live-birth rates (42.6% vs. 35.5%) in the study group and controls.
  
  
  CONCLUSIONS
  The results show that MPA is an effective oral alternative for the prevention of premature LH surge in woman undergoing COH. This finding will help establish a new regimen for ovarian stimulation in combination with embryo cryopreservation.
  
  
  BACKGROUND
  ChiCTR-ONRC-14004419.
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China. Electronic address: Kuangyanp@126.com.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Kuang
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Qiuju
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Yonglun
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Hong
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Qifeng
authors.initials: Q
authors.lastname: Lyu
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Ai
authors.initials: A
authors.lastname: Ai
authors.affiliation: Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Zeev
authors.initials: Z
authors.lastname: Shoham
mesh_terms: D000284:Administration, Oral; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000628:therapy*; D007986:Luteinizing Hormone / Q000037:antagonists & inhibitors* / Q000097:blood; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D054315:Oocyte Retrieval / Q000379:methods*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D003271:Contraceptive Agents, Female; D007986:Luteinizing Hormone; D017258:Medroxyprogesterone Acetate
keywords: Medroxyprogesterone acetate; controlled ovarian stimulation; premature LH surge