Oocyte recruitment of patients submitted to the new ovarian stimulation regimen using progestin to block the LH surge

Abstract

To evaluate the recruitment and oocyte maturity of a new low cost and easy administration ovarian stimulation regimen, which uses progestin as an alternative to the GnRH analogue. Cross-sectional study. It was analyzed 100 patients who underwent Assisted Human Reproduction between June 2018 to January 2019. Of those patients, 50 used the progestin protocol as an alternative to the GnRH analogue, to suppress the premature LH surge during the follicular phase. The other 50 patients used the standard protocol with antagonist. The total number of oocytes retrieved and the classification for maturity and viability were analyzed between the groups. Variables such as age and body mass index (BMI) were considered as well. The qualitative variables were presented by absolute and relative frequency and the quantitative variables by means of a 95% confidence interval, using a normality test of the Shapiro-Wilk data (p <0.05). The Mann-Whitney test and Chi-square test were used to compare the variables according to the two induction protocols. The Chi-square test was used for the comparative analysis of the BMI. For all analyzes, the level of significance was p <0.05. The statistical program used was Stata version 11.0. No statistically significant results were found in relation to the number of oocytes retrieved in the conventional ovarian stimulation cycles with antagonist compared to the cycles using progestin to block the LH surge (283 versus 247, p = 0.54). Similarly, there was no difference in the degree of oocyte maturation (mature 79.72% / 77.43%, immature 13.52% / 15.68%), altered, degenerated or oocytes with ruptured zona pellucida (2.54% / 2.19%, 1.13% / 1.88%, 3.10% / 2.82%, p = 0.88). The body mass index (BMI) was also evaluated without significant differences after analysis (p = 0.07). When separated by age (up to 37 years and ≥ 38 years), the groups also did not present statistically significant differences in any of the analyzed variables. The use of progestin in the induction protocols to block the LH surge seems to be an option in the substitution of GnRH analogues, since it presented similar results, more accessible cost and a route of administration more comfortable for the patients.