Volume 20, Issue 6 (June 2022)                   IJRM 2022, 20(6): 491-500 | Back to browse issues page

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Singh E, Blockeel C, Singh M, Gupta R, Kamdi S. Evaluation of pregnancy outcomes using medroxyprogesterone acetate versus gonadotropin-releasing hormone antagonist in ovarian stimulation: A retrospective cohort study. IJRM 2022; 20 (6) :491-500
URL: http://ijrm.ir/article-1-2016-en.html
Evaluation of pregnancy outcomes using medroxyprogesterone acetate versus gonadotropin-releasing hormone antagonist in ovarian stimulation: A retrospective cohort study
Ekika Singh * 1, Christophe Blockeel2 , Madhulika Singh3 , Rishi Gupta4 , Sandesh Kamdi5
1- Sharda Narayan Hospital, Mau, UP, India. , ekika.singh@snhospital.org
2- Centre for Reproductive Medicine, Laarbeeklaan, Brussels, Belgium.
3- Sharda Narayan Hospital, Mau, UP, India.
4- Manokalp Clinic, Delhi, India.
5- Pacific Academy of Higher Education and Research University, Udaipur, Rajasthan, India.
Abstract:   (1277 Views)
Background: Limited studies have compared pregnancy outcomes with medroxyprogesterone acetate (MPA) vs. gonadotropin-releasing hormone antagonist (GnRH antagonist) in ovarian stimulation protocols. The results show heterogeneity.
Objective: This study aims to assess pregnancy outcomes with the use of MPA instead of GnRH antagonist for ovarian stimulation in donor-recipient cycles.
Materials and Methods: This retrospective study was carried out from June 2016 to May 2019. The study included 250 donors receiving ovarian stimulation with 2 different protocols: group 1 (n = 109) receiving GnRH antagonist (0.25 mg/day) from the 5th or 6th  day of menses and group 2 (n = 141) receiving MPA (10 mg/day) from the second day of menses. In 384 recipients, 2 good-quality blastocysts were transferred after endometrial preparation. The primary endpoint was live birth in recipients.
Results: The results showed that live birth was comparable in both recipient groups (59% vs. 60%, OR: 0.63, 95% CI: 0.13-2.99, p = 0.559). The number of live-born fetuses (adjusted OR: 0.57, 95% CI: 0.31-1.05, p > 0.01) showed no significant difference in both groups. However, the implantation rate with twin sacs was significantly lower in group 2 (adjusted OR: 0.57, 95% CI: 0.33-0.99, p = 0.05). The regression analysis for goodquality blastocyst proportion was comparable (OR: 0.63, 95% CI: -4.33-5.60, p = 0.802) in both donor groups. The mean stimulation cost in group 2 was less than in group 1.
Conclusion: MPA had a comparable live birth and embryological outcomes in both groups. Oral administration makes it convenient, acceptable, and patient-friendly. Its cost-effectiveness and convenience open new possibilities in ovarian stimulation protocols.
Keywords: Oocyte donation, Medroxyprogesterone acetate, Gonadotropin-releasing hormone antagonist, Pregnancy outcomes.
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Type of Study: Original Article | Subject: Assisted Reproductive Technologies
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