Euploidy rates among first preimplantation genetic testing for aneuploidy cycles treated by oral dydrogesterone primed ovarian stimulation or the flexible gonadotropin-releasing hormone antagonist protocol

ABSTRACT

Research question

Are there differences in euploidy rates in PGT-A cycles with oral dydrogesterone (DYG) primed ovarian stimulation protocol or the flexible gonadotropin-releasing hormone antagonist (GnRH-ant) protocol.

Design

This was a retrospective cohort study. Patients received the dydrogesterone (DYG) or the GnRH-ant protocol (ANT) in the first PGT-A cycle between November 2017 and May 2019. Propensity matching was used to identify a propensity-matched ANT group based on age, BMI and AMH with a 1:1 ratio. The primary outcome was the rate of euploid embryos.

Results

This study included 780 cycles which consisted of 390 cycles receiving the dydrogesterone and 390 cycles receiving the GnRH-ant protocol. There is no significant difference in patient baseline and cycle characteristics in the two groups. There existed no statistical difference in the number of oocytes retrieved, MII oocytes, embryos biopsied, and embryos testing between the two groups. Due to no biopsy blastocysts formed in some cycles, only 262 cycles in the study group and 263 cycles in the ANT group received NGS testing, respectively. Similar to our overall data, the euploid rate per embryo biopsied was not significantly different. There were no significant differences between the two groups after stratifying by age and controlling for PGT-A testing modality.

Conclusions

Ovulation inhibition by exogenous progestins in ovarian stimulation cycles should therefore be considered a valid option for modality in freeze-all PGT-A cycles, in view of its demonstrated effectiveness and known safety enhancement.