PPOS DNG vs. DYG 2018.2-2019.11
Study question Is it effective for patients taking dienogest to use progestin-primed ovarian stimulation (PPOS) protocol during controlled ovarian hyperstimulation (COH), compared to PPOS with dydrogesterone (DYG)? Study answer Patients taking dienogest can continue the endometriosis treatment and get good quality embryo using PPOS during COH, despite they have severe ovarian endometriosis. What is known already Dienogest is an oral progestin effective for the treatment of symptomatic endometriosis, such as reduction of endometrial lesion and control of pain intensity with safe profile and good tolerability. Dienogest also provides complete ovulation inhibition at a daily dose of 2mg, and a rapid recovery of ovarian function after cessation of its administration. PPOS is a new COH regimen using a progestin as alternative to GnRH antagonist for blocking LH surge, and several reports have shown that DYG is an appropriate progestin for PPOS protocol. However, dienogest has not been used in PPOS protocol yet. Study design, size, duration This was a prospective controlled study of 145 women with endometriosis (aged <41) undergoing COH for IVF/ICSI and frozen embryo transfer (FET) at our infertility center from February in 2018 to May in 2020. The patients taking dienogest were allocated in the Study group, and the other patients taking PPOS with DYG were allocated in the Control group. Participants/ Materials, setting, methods A total of 145 patients were analyzed, PPOS with DNG: 71 patients, PPOS with DYG: 74 patients. Patients took DNG 2mg continuously in DNG group, and DYG were started day 3 of COH cycle. Patients were administrated with 150-225 IU of human menopausal gonadotropin (hMG) daily for COH. All viable embryos were cryopreserved for later transfer. The primary outcome measure was the clinical pregnancy rate.