Results
Out of 995 women who met the
selection criteria, 509 women used the PPOS protocol while 486 women
used the long agonist protocol. One woman
in the PPOS group had premature
ovulation before oocyte retrieval. No transferable embryos were
available in 61women in the PPOS
group and 19 women in the long
agonist group resulting in cycle
cancellation, the cancellation rate was significantly higher in the PPOS
group than in the agonist group (12.0% versus 3.9%, p <
0.001). Within 18 mouth follow up,
76
(14.9%)women in the PPOS group and 55 (11.3%) women in the agonist
group who did not achieve live birth but still have cryopreserved
embryos were also included for analysis (Figure1).
Demographic and the index
stimulation cycle characteristics
Baseline characteristics of two groups are presented in Table I. No
significant differences were found
with regard to age of women, basal AFC, basal FSH level, number of
previous IVF cycles, body mass index, cause of infertility, proportion
of primary infertility and insemination methods between the two groups
except for duration of infertility, which was significantly shorter in
the PPOS group compared to that in the long agonist group.
The starting dose of FSH was higher (225 IU versus 150 IU, P <
0.001), days of stimulation is shorter (8 days versus 11
days, P < 0.001) and
total
FSH dose was lower (1800 IU versus
2025 IU, P < 0.001) in the
PPOS group compared to those in agonist group. Serum estradiol levels
(2740 pg / ml
versus 2496 pg / ml, P <
0.05) and LH level on HCG day (2.6 IU/ml versus
0.7
IU/ml, P < 0.001) was
higher in the PPOS groups than those in the long agonist group. However,
there was no significant difference in the serum progesterone level on
the hCG day between the two groups. One women in the PPOS groups
experienced premature LH surge while none was seen in the long agonist
group. No patient experienced OHSS in the PPOS groups, while 4 patients
(0.8%) in the long agonist group were administered into hospital due to
moderate or severe OHSS. (Table 1)
Average number of oocytes
obtained
(9 versus 12, P < 0.001),
number of oocytes fertilized (7 versus 8, P < 0.001), number
of cleaving embryos (6 versus 8, P
< 0.001) and number of transferable embryos (3 versus
4, P < 0.001) was lower in
the PPOS group as compared to that in the long agonist group. However,
no differences were found in fertilization rate, cleavage rate, number
of blastocyst formation and number of good quality embryos between the
two groups (Table I) .