Abstract
Background: To investigate the optimal ovulation trigger–oocyte pickup (OPU) interval of a progestin-primed ovarian stimulation (PPOS) protocol.Method: Patients with normal ovarian reserve in their first PPOS OPU cycle were enrolled in this retrospective cohort study between July 2013 and April 2018. This retrospective cohort study included two parts. In part I, we studied the regression trend of mature oocyte rate, implantation rate, and live birth rate within the whole ovulation trigger–OPU interval of 7,258 patients. To homogenize some clinical characters that were key regulators of OPU time, in part II, we used propensity score matching to auto-select patients among trigger–OPU interval group 1 (35.6–36.4 h), group 2 (36.4–37.1 h), and group 3 (37.1–37.8 h) and analyzed clinical outcomes.Results: Study part I showed that the whole ovulation trigger–OPU interval (33–39.5 h) of PPOS protocol had a trend of a high mature oocyte rate (>80%), increasing implantation rate, and high live birth rate. Propensity score matching of patients with homogeneous clinical characteristics further indicated that the trigger–OPU interval within groups 2 and 3 (36.4–37.8 h) had significantly higher mature oocyte rates (84.54% vs. 84.60% vs. 82.34%, P = 0.002) and implantation rates (34.17% vs. 34.37% vs. 29.61%, P < 0.05) than group 1. The same tend was observed in the live birth rate.Conclusions: The ovulation trigger–OPU interval of 36.4–37.8 h is optimal for most patients using a PPOS protocol.
Highlights
The interval from trigger to oocyte pickup (OPU) is the period of in vivo oocyte maturation that has a predominant effect on assisted reproductive technology success
This study aimed to explore the optimal ovulation trigger–OPU interval of the progestin-primed ovarian stimulation (PPOS) protocol that is universally used in our center, using a retrospective analysis of a huge number of patients
Propensity score matching (PSM) has its advantage in the retrospective analysis of optimal trigger–OPU interval in controlled ovarian hyperstimulation (COH) protocols; the patients who were auto-matched by this method had the similar basic and clinic characteristics in superovulation, which let the analysis focus on the trigger– OPU interval and reduce other confounders
Summary
The interval from trigger to oocyte pickup (OPU) is the period of in vivo oocyte maturation that has a predominant effect on assisted reproductive technology success. A new COH protocol, PPOS has proven effective for patients with a normal response, diminished ovarian reserve, polycystic ovarian syndrome, and high body mass index (BMI) [6, 8, 10, 11] It has a different mechanism, hypothalamic action, to prohibit the premature LH surge than other COH protocols [12]. The different follicular hormonal environment in the PPOS protocol may lead to a diversity of cytokines in the follicular fluid, which may influence the optimal trigger–OPU interval [13] It is popular among patients and has a promising clinical application, no studies have focused on whether different trigger–OPU intervals will influence oocyte performance and pregnancy rates of the PPOS protocol nor have they identified the optimal interval. To investigate the optimal ovulation trigger–oocyte pickup (OPU) interval of a progestin-primed ovarian stimulation (PPOS) protocol
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
