title: The pregnancy outcome of progestin-primed ovarian stimulation using 4 versus 10 mg of medroxyprogesterone acetate per day in infertile women undergoing in vitro fertilisation: a randomised controlled trial.
abstract: OBJECTIVE
  To investigate the clinical outcome and endocrinological characteristics of progestin-primed ovarian stimulation (PPOS) using 4 versus 10 mg of medroxyprogesterone acetate (MPA) per day in infertile women with normal ovary reserve.
  
  
  METHODS
  A randomised parallel controlled trial.
  
  
  METHODS
  Tertiary-care academic medical centre.
  
  
  METHODS
  A cohort of 300 infertile women undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) treatment.
  
  
  METHODS
  Human menopausal gonadotropin (hMG; 225 iu per day) and MPA (group A, 10 mg per day; group B, 4 mg per day) were started simultaneously from cycle day 3 onwards. Ovulation was co-triggered by human chorionic gonadotropin (hCG; 1000 iu) and gonadotropin-releasing hormone agonist (GnRH agonist; 0.1 mg) when dominant follicles matured. Viable embryos were cryopreserved for later frozen embryo transfer (FET) in both groups.
  
  
  METHODS
  The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the incidence of a premature surge in luteinising hormone (LH), the number of viable embryos, and clinical pregnancy outcomes.
  
  
  RESULTS
  The number of oocytes retrieved and viable embryos were similar between two groups (9.8 ± 6.3 versus 9.6 ± 5.9; 4.2 ± 2.6 versus 3.7 ± 3.0; P > 0.05). No significant difference was found in clinical pregnancy rate (58.0 versus 48.7%) and live birth rate per participant (48.7 versus 42.0%; P > 0.05). No premature LH surge and ovarian hyperstimulation syndrome (OHSS) occurred in either group.
  
  
  CONCLUSIONS
  Progestin-primed ovarian stimulation (PPOS) using 4 or 10 mg of MPA per day was comparable in terms of the number of oocytes retrieved and pregnancy outcome after FET. The administration of 4 mg of MPA per day was sufficient to prevent an untimely LH rise in women undergoing IVF/ICSI treatment.
  
  
  CONCLUSIONS
  An RCT confirmed similar pregnancy outcome in P-primed ovarian stimulation with a daily dose of 4 or 10 mg MPA.
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: W R
authors.initials: WR
authors.lastname: Chai
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Q Q
authors.initials: QQ
authors.lastname: Hong
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: N L
authors.initials: NL
authors.lastname: Wang
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: L H
authors.initials: LH
authors.lastname: Sun
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: Long
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: Tian
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Q F
authors.initials: QF
authors.lastname: Lyu
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: X F
authors.initials: XF
authors.lastname: Lu
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Q J
authors.initials: QJ
authors.lastname: Chen
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Y P
authors.initials: YP
authors.lastname: Kuang
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D054315:Oocyte Retrieval / Q000379:methods; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011372:Progestins / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin; D011372:Progestins; D007986:Luteinizing Hormone; D017258:Medroxyprogesterone Acetate
keywords: Controlled ovarian stimulation; luteinising hormone surge; progestin