P-672 Progestin primed ovarian stimulation: whether there is an effect on embryo euploidy and pregnancy rate in IVF programs with donor oocytes
Authors: Abshekenova A , Karibayeva S , Lokshin V , Valiyev R , Rybina A , Askar Y 
Published: June 2022

Abstract

Study question
Is there a difference in euploid embryo rates and pregnancy rates in IVF programs with donor oocytes after PPOS and GnRH-antagonist programs ?

Summary answer
We report no difference in euploid embryo rates and pregnancy rates in IVF programs with donor oocytes after PPOS and GnRH-antagonist programs.

What is known already
Before the advances in vitrification techniques, it was impossible to consider the feasibility of using steroids during controlled ovarian stimulation since it negatively impacts endometrial receptivity. Since it is possible to cryopreserve and thaw embryos, the frozen-embryo transfer has been widely used.
Progesterone soft gels have recently been shown to be an effective oral alternative for preventing premature LH surges during COH in normally ovulating women undergoing IVF/ICSI procedures with optimal pregnancy outcomes at transfer frozen-thawed embryos cycles. Thus, PPOs may be a priority choice for ovarian stimulation in the cycle of fertility preservation, oocyte donation, and preimplantation genetic testing.

Study design, size, duration
A retrospective cohort study of 201 IVF/ICSI programs with donor oocytes from January 2018 to September 2020.

Participants/materials, setting, methods
All programs were divided into 2 groups: 1 st group - 123 programs for the stimulation of oocyte donors with progestins primed ovarian stimulation, 2nd group - 93 programs with Cetrorelix as an LH peak blocker. We compared the number of mature oocytes, fertilization rate, blastulation rate, blastocyst and TQB quality, and euploid embryo rate after the preimplantation genetic screening with aCGH.

Main results and the role of chance
In our study, there were no statistically significant differences in the dose of gonadotropins in the groups, but the number of injections in the α group was less due to the exclusion of parenteral administration of antagonists and agonists, which improved the quality of life of donors during stimulation. There were no cases of stimulation complications in any group. The number of mature oocytes in both groups of oocyte donors did not differ (80 vs. 81%, respectively p ∠0.001.). The percentage of fertilization (80.8% in the 1st group and 77.5% in the 2nd group) and the frequency of blastulation (51.4% in the 1st group and 53.5% in the 2nd group) did not have significant differences both in the group with Utrozhestan and in the group with Cetrorelix. . The number of TQBs (68.8% vs. 66.4%) p∠0.001. and the level of euploid embryos in both groups was the same (51% vs. 59%) p ∠0.05.
The pregnancy rate in both groups also did not differ significantly (50.7% in the 1st group versus 41.5% in the 2nd group p∠ 0.001.).

Limitations, reasons for caution
The limitations are related to the study design. More research is also needed.

Wider implications of the findings
Thus, the progesterone protocol is effective, safe, convenient for oocyte donation, for patients with spontaneous ovulation in previous stimulation protocols, for patients with confirmed follicular luteinization in previous stimulation protocols.
PPOS does not worsen the pregnancy rate and the number of euploid embryos in the program with donor oocytes.

Trial registration number
not applicable