Influence of Initiating the PPOS Protocol at Different Menstrual Cycles on Outcome of Assisted Reproduction in Patients with Diminished Ovarian Reserve
XING Jingjing, MA Xinxiang, LIU Min, et al
Department of Reproductive Genetics, Zhengzhou Maternal and Child Health Hospital, Zhengzhou Henan 450000
Abstract:【Objective】To explore the impact of different menstrual cycle initiation of high progesterone state ovulation induction (progesterone primed ovarian stimulation, PPOS) on the pregnancy outcomes of patients with diminished ovarian reserve (DOR). 【Methods】A retrospective analysis was conducted on the clinical data of 216 DOR patients who underwent PPOS treatment in our hospital from January 2018 to December 2023. The patients were divided into the follicular phase initiation group (Group A, n=114) and the luteal phase initiation group (Group B, n=102) based on the initiation timing. The number of retrieved oocytes, the rate of metaphase Ⅱ(MⅡ) oocytes, the number of available embryos, the rate of high-quality embryos on day 3 (D3) of cleavage, clinical pregnancy rate, live birth rate, total dose of gonadotropin (Gn) drugs, the duration of Gn drug use, cycle cancellation rate, and the incidence of ovarian hyperstimulation syndrome (OHSS) were compared between the two groups. 【Results】The number of retrieved oocytes and the MⅡ oocyte rate in Group A were higher than those in the Group B, with statistically significant differences (P<0.05). There were no statistically significant differences in the number of available embryos, the rate of high-quality embryos on D3, clinical pregnancy rate, live birth rate, cycle cancellation rate, and the incidence of OHSS between the two groups (P>0.05). The total dose of Gn drugs and the duration of Gn drug use in Group A were less than those in Group B, with statistically significant differences (P<0.05). 【Conclusion】The follicular phase initiation PPOS protocol can increase the number of retrieved oocytes and the rate of mature oocytes in DOR patients, and can reduce the dose of ovulation induction drugs and the duration of ovulation induction, but it does not significantly improve the clinical pregnancy rate and live birth rate.
邢晶晶, 马新想, 刘敏, 张富青. 不同月经周期启动PPOS方案对卵巢储备功能减退患者助孕结局的影响[J]. 医学临床研究, 2025, 42(11): 1921-1923.
XING Jingjing, MA Xinxiang, LIU Min, et al. Influence of Initiating the PPOS Protocol at Different Menstrual Cycles on Outcome of Assisted Reproduction in Patients with Diminished Ovarian Reserve. JOURNAL OF CLINICAL RESEARCH, 2025, 42(11): 1921-1923.
[1] 梁坤铃,茹银转,叶燕霞.血清、宫颈黏液抗米勒管激素、MMP/TIMP平衡结合阴道超声检查在二胎备孕妇女卵巢储备功能评估中的应用[J].海军医学杂志,2024,45(7):715-719.
[2] 靳冬梅,伍东月,杜瑞亭,等.腹腔镜下卵巢囊肿剔除术中电凝和缝合止血对卵巢储备功能的影响[J].中国现代医学杂志,2022,32(6):18-23.
[3] ZHU Q Y, LI Y, MA J H, et al. Potential factors result in diminished ovarian reserve: a comprehensive review[J].J Ovarian Res,2023, 16(1): 208.
[4] 陈镝,谢雅婷,郭闻亚,等.POSEIDON标准及其在辅助生殖中的应用[J].中华生殖与避孕杂志,2022,42(1):80-85.
[5] 王洁楠.排卵障碍性不孕症中西医结合诊疗指南的研究[D].北京:中国中医科学院,2023.
[6] 田海清,毛新敏,巩晓芸,等.在IVF中卵巢储备低下患者添加脱氢表雄酮(DHEA)有效性的Meta分析[J].生殖与避孕,2014,34(12):997-1003.
[7] ZHANG Q L, LEI Y L, DENG Y, et al. Treatment progress in diminished ovarian reserve: Western and Chinese medicine[J].Chin J Integr Med,2023, 29(4): 361-367.
[8] PECKER L H, HUSSAIN S, MAHESH J, et al. Diminished ovarian reserve in young women with sickle cell anemia[J].Blood,2022, 139(7): 1111-1115.
[9] 李佳霖,孙永,张硕.PPOS方案与拮抗剂方案对卵巢低反应患者IVF-ET助孕结果的影响[J].中华内分泌外科杂志,2021,15(6):657-660.
[10] 唐亭亭,柳朝华,吴晓丽.脱氢表雄酮联合辅酶Q10在卵巢储备功能下降不孕患者体外授精-胚胎移植中的应用价值[J].医学临床研究,2022,39(8):1254-1256.
[11] 罗玉萍,黄官友,赵淑云.两种孕激素在卵泡期高孕激素状态下促排卵方案中治疗效果的比较[J].生殖医学杂志,2021,30(9):1164-1168.
[12] 樊秀梅,杨丽,赵岗,等.超声评估子宫内膜下的RI、PI、PSV值预测不孕患者子宫内膜状况及卵巢储备功能的研究[J].河北医科大学学报,2023,44(9):1047-1052.
[13] 冯月枝,关少艮,黄永汉.高孕激素状态下促排卵方案在PCOS患者IVF-ET临床疗效的Meta分析[J].生殖医学杂志,2022,31(4):482-493.
[14] 思美丽,史帆.围绝经期综合征女性卵巢储备功能与甲状腺功能的相关性分析[J].医学临床研究,2022,39(9):1392-1394.
[15] 徐小娅.高龄卵巢储备功能低下患者应用不同促排卵方案的临床结局分析[D].郑州:郑州大学,2021.