Hong Chen

and 8 more

Background There is scarcity of information about the cumulative live birth rates(CLBRs) and time to live birth(TTLB) between progestin primed ovarian stimulation protocol(PPOS) and long GnRH agonist protocol. Objective To compare CLBRs and TTLB in women with normal ovarian reserve following PPOS with long GnRH agonist protocol. Methods A total of 995 women who underwent IVF using either PPOS (n=509) or GnRH antagonist (n=486) ovarian stimulation at the discretion of the attending physicians. The primary outcome measure was the CLBRs within 18 months from the day of ovarian stimulation. Results Both groups had almost comparable demographic and cycle stimulation characteristics except for duration of infertility which was shorter in the PPOS group. CLBRs after one complete IVF cycle including fresh and subsequent FET cycles within 18 months follow up were significantly lower in the PPOS group compared that in the long agonist group 206/509 (40.5%) and 307/486 (63.2%), respectively (odds ratio (OR): 0.641; 95% CI: 0.565-0.726). The average TTLB was significantly shorter in the long agonist group compared to the PPOS group (P < 0.01). In Kaplan-Meier analysis, the cumulative incidence of ongoing pregnancy leading to LB was significantly higher in the long agonist compared in the PPOS group (P < 0.001). Cox regression analysis revealed stimulation protocol adopted was strongly associated with the CLBRs after adjusting other confounding factors (OR =1.917 (1.152-3.190), P=0.012). Conclusion PPOS offers no advantage over conventional protocol in women with a normal ovarian reserve undergoing IVF. Keywords: PPOS, long GnRH agonist protocol, IVF, CLBRs, TTLB