Introduction
The effects of assisted reproductive technology on the outcomes of twin pregnancies are controversial. Therefore, the purpose of this study was to compare the maternal and perinatal ...outcomes of twin pregnancies conceived spontaneously and those conceived by assisted reproductive technology.
Material and methods
This was a cross‐sectional study performed at Peking Union Medical College Hospital (PUMCH). Data on twin pregnancies (conceived spontaneously and by in vitro fertilization IVF/intracytoplasmic sperm injection ICSI) were obtained from the National Birth Registry of China for the period between 1 October 2016, and 30 September 2017. The primary obstetric outcomes were compared between twin pregnancies conceived by different methods. Logistic regression analysis with 95% confidence intervals (95% CI) was used for the multivariate analysis.
Results
A total of 3270 twin pregnancies (2003 and 1209 conceived spontaneously and by IVF/ICSI, respectively) were identified. The proportion of twin pregnancies among all pregnancies was 3.4% (3332/97 278). Multiple regression analysis indicated that the incidences of gestational diabetes mellitus (adjusted odds ratio AOR = 1.42, 95% CI 1.10–1.83, p = 0.007), preterm premature rupture of membranes (AOR = 1.65, 95% CI 1.21–2.25, p = 0.002), placenta accreta spectrum (AOR = 2.12, 95% CI 1.42–3.17, p < 0.001) and postpartum hemorrhage (AOR = 1.38, 95% CI 1.02–1.86, p = 0.037) were significantly higher in the IVF/ICSI group than in the natural pregnancy group. Multivariate analysis also revealed that conception mode was not an independent risk factor for neonate outcomes.
Conclusions
In twin pregnancies, IVF/ICSI is independently associated with multiple maternal complications, including gestational diabetes mellitus, preterm premature rupture of membranes and placenta accreta spectrum compared with spontaneous conception, although potential residual confounders due to indications for assisted reproductive technology exist.
To establish the relationship between follitropin delta doses (recombinant follicle-stimulating hormone produced from the human cell line PER.C6) and ovarian response in Japanese women undergoing ...in vitro fertilization/intracytoplasmic sperm injection treatment and to evaluate the influence of initial antimüllerian hormone (AMH) levels.
Randomized, controlled, assessor-blind, AMH-stratified (low 5.0–14.9 pmol/L; high 15.0–44.9 pmol/L) dose-response trial.
Reproductive medicine clinics.
A total of 158 Japanese women (20–39 years of age).
Controlled ovarian stimulation with 6, 9, or 12 μg/d of follitropin delta or 150 IU/d follitropin beta as a reference arm in a gonadotropin-releasing hormone antagonist cycle.
Number of oocytes retrieved.
Among all women who started stimulation, the mean number (± standard deviation) of oocytes retrieved in the 6 μg/d, 9 μg/d, and 12 μg/d follitropin delta groups was 7.0 ± 4.1, 9.1 ± 5.6, and 11.6 ± 5.6, respectively, and a significant dose-relation was established, which also remained significant within each AMH strata. Significant dose-responses also were observed for serum estradiol, inhibin A, and progesterone at end-of-stimulation with follitropin delta. The vital pregnancy rate per started cycle with follitropin delta was 19% for 6 μg/d, 20% for 9 μg/d, and 25% for 12 μg/d. The rate of early moderate/severe ovarian hyperstimulation syndrome with follitropin delta was 8% for 6 μg/d, 8% for 9 μg/d, and 13% for 12 μg/d, with 82% of the cases in the high AMH stratum.
This trial establishes the dose-response relationship between follitropin delta and ovarian response in Japanese women.
NCT02309671.
Ensayo aleatorizado dosis-respuesta, con evaluador ciego, estratificado por hormona antimülleriana en pacientes japonesas de fecundación in vitro/ inyección intracitoplasmática de espermatozoides que se sometieron a estimulación ovárica controlada con foltropina delta.
Establecer la relación entre dosis de folitropina delta (hormona folículo-estimulante recombinante producida de la línea celular humana PER.C6) y respuesta ovárica en mujeres japonesas que se sometieron a tratamiento de fecundación in vitro/ inyección intracitoplasmática de espermatozoides y evaluar la influencia de los niveles iniciales de hormona antimülleriana (AMH).
Ensayo aleatorizado dosis-respuesta, controlado, con evaluador ciego, estratificado por AMH (bajo 5.0-14.9 pmol/L; alto 15.0-44.9 pmol/L)
Clínicas de medicina reproductiva.
Un total de 158 mujeres japonesas (20-39 años).
Estimulación ovárica controlada con 6, 9, o 12 μg/d de folitropina delta o 150 UI/d de folitropina beta como rama de referencia en ciclo con antagonista de la hormona liberadora de gonadotropinas.
Número de ovocitos recuperados.
Entre las mujeres que iniciaron estimulación, la media (± desviación estándar) de ovocitos recuperados en los grupos 6 μg/d, 9 μg/d, y 12 μg/d de folitropina delta fue 7.0 ± 4.1, 9.1 ± 5.6 y 11.6 ± 5.6, respectivamente, y se estableció una relación-dosis significativa, la cual también se mantuvo significativa dentro de cada estrato de AMH. También se observaron dosis-respuestas significativas para estradiol sérico, inhibina A, y progesterona al final de la estimulación con folitropina delta. La tasa de embarazo por ciclo iniciado con folitropina delta fue 19% para 6 μg/d, 20% para 9 μg/d, y 25% para 12 μg/d. La tasa de síndrome de hiperestimulación ovárica moderado/ severo temprano con folitropina delta fue 8% para 6 μg/d, 8% para 9 μg/d y 13% para 12 μg/d, con 82% de los casos en el estrato alto de AMH.
Este ensayo establece la relación dosis-respuesta entre folitropina delta y respuesta ovárica en mujeres japonesas.
To measure in vitro fertilization (IVF) outcomes following 24-chromosome single‒nucleotide-polymorphism (SNP)–based preimplantation genetic testing for aneuploidy (PGT-A) and euploid embryo transfer.
...Retrospective.
Fertility clinics and laboratory.
Women 20–46 years of age undergoing IVF treatment.
Twenty-four-chromosome SNP-based PGT-A of day 5/6 embryo biopsies.
Maternal age–stratified implantation, clinical pregnancy, and live birth rates per embryo transfer; miscarriage rates; and number of embryo transfers per patient needed to achieve a live birth.
An implantation rate of 69.9%, clinical pregnancy rate per transfer of 70.6%, and live birth rate per transfer of 64.5% were observed in 1,621 nondonor frozen cycles with the use of SNP-based PGT-A. In addition, SNP-based PGT-A outcomes, when measured per cycle with transfer, remained relatively constant across all maternal ages; when measured per cycle initiated, they decreased as maternal age increased. Miscarriage rates were ∼5% in women ≤40 years old. No statistically significant differences in pregnancy outcomes were found for single-embryo transfers (SET) versus double-embryo transfers with SNP-based PGT-A. On average, 1.38 embryo transfers per patient were needed to achieve a live birth in nondonor cycles.
Our findings that SNP-based PGT-A can mitigate the negative effects of maternal age on IVF outcomes in cycles with transfer, and that pregnancy outcomes from SET cycles are not significantly different from those of double-embryo transfer cycles, support the use of SET when transfers are combined with SNP-based PGT-A.
Resultados de embarazos de más de 1800 ciclos de fecundación in vitro mediante polimorfismosde nucleótido único en 24 cromosomas basado en el diagnóstico genético preimplantacional para aneuploidías
Medir los resultados de fecundación in vitro (FIV) con el uso de polimorfismos de nucleótido único en 24 cromosomas (SNP) basado en el estudio genético preimplantacional para aneuploidías (PGT-A) y transferencia de embriones euploides.
Retrospectivo.
Clínicas y Laboratorios de Fertilidad.
Mujeres de 20 a 46 años de edad sometidas a tratamientos de FIV.
Polimorfismo de nucleótido único de 24 cromosomas basado en el estudio genético preimplantacional para aneuploidías de biopsias de embriones de día 5/6.
Implantación estratificada por edad materna, embarazo clínico y tasa de recién nacido vivo por embrión transferido; tasas de pérdida/aborto y número de transferencias embrionarias por paciente necesarias para lograr un recién nacido vivo.
Se observó una tasa de implantación de 69,9%, una tasa de embarazo clínico por transferencia de 70,6% y una tasa de recién nacido vivo por transferencia de 64,5% en 1621 ciclos congelados de pacientes no donantes con el uso del SNP PGT-A. Además al medir los resultados de SNP PGT-A en ciclos donde hubo transferencias, estos se mantuvieron relativamente constantes a través de todas las edades maternas; al momento de medir los resultados por ciclo iniciado, estos disminuyeron a la vez que la edad materna aumentaba. La tasa de pérdida/aborto fue de aproximadamente 5% en mujeres ≤ 40 años de edad. No se hallaron diferencias estadísticamente significativas en los embarazos donde hubo transferencia de un solo embrión (SET) versus aquellos con transferencias de dos embriones y el uso de SNP PGT-A. Un promedio de 1,38 transferencias embrionarias por paciente fueron necesarias para lograr un recién nacido vivo en ciclos de no donantes.
Nuestros hallazgos muestran que el uso de SNP PGT-A puede mitigar los efectos negativos de la edad materna en los resultados de FIV en los ciclos donde hubo transferencias; y que los resultados de embarazo con ciclos de SET no son significativamente diferentes a aquellos ciclos en los que hubo transferencias de dos embriones, lo que apoya el uso de SET cuando las transferencias embrionarias son combinadas con el uso de SNP PGT-A.
Objective To determine the effect of maternal age on the average number of euploid embryos retrieved during oocyte harvest as part of an in vitro fertilization (IVF) cycle, including the probability ...of retrieving at least one euploid embryo in a cohort (PrE). Design Retrospective study. Setting Preimplantation genetic screening (PGS) laboratory. Patient(s) Women aged 18 to 48 years undergoing IVF treatment. Intervention(s) Use of 24-chromosome single-nucleotide polymorphism (SNP)-based PGS of day-3 and day-5 embryo biopsies. Main Outcome Measure(s) Relationships between maternal age and the rate of embryos that tested as euploid (hereafter referred to as “euploid embryos”), the average number and proportion of euploid embryos per IVF cycle, and PrE. Result(s) We analyzed 22,599 day-3 embryos and 15,112 day-5 embryos. In women aged 27 to 35 years, the median proportion of euploid embryos in each cycle remained constant at ∼35% in day-3 biopsies and ∼55% in day-5 biopsies, but it decreased rapidly after age 35. On average, women in their late 20s had four euploid embryos (day 3 or day 5) per cycle, but this number decreased linearly (R2 ≥ 0.983) after 35 years of age. The effect of maternal age on PrE was similar, with a rapid exponential decline (R2 = 0.986). Across all maternal ages, the euploid proportion and number of embryos per cycle were counterbalanced, so the number of euploid embryos per cycle was the same for day-3 and day-5 biopsies. This suggests that the loss of embryos from day 3 to day 5 was primarily due to aneuploidy. Conclusion(s) Our results confirm the known inverse relationship between advanced maternal age (>35 years) and embryo euploidy, demonstrating that equal numbers of euploid embryos are available at day 3 and day 5.
Artificial reproduction involves collection and handling of gametes in a way that secures their quality and maximizes the fertilization outcome. In addition to initial sperm quality, numerous steps ...can affect the final result of fertilization, from the sperm collection process until gamete mixing (or co-incubation) when the spermatozoon enters or fuses with the oocyte. In this review, we summarize the whole process of sperm handling, from collection until fertilization for fish, penaeid shrimp, bivalve mollusks and marine mammals. To obtain sperm from captive animals, techniques vary widely across taxa, and include stripping by abdominal massage or testis surgical removal in fish, spermatophore collection in penaeid shrimps, gonadal scarification or temperature shock in bivalve mollusks, and voluntary collection via positive reinforcement in mammals. In most cases, special care is needed to avoid contamination by mucus, seawater, urine, or feces that can either activate sperm motility and/or decrease its quality. We also review techniques and extender solutions used for refrigerated storage of sperm across the aforementioned taxa. Finally, we give an overview of the different protocols for in vivo and in vitro fertilization including activation of sperm motility and methods for gamete co-incubation. The present study provides valuable information regarding breeder management either for animal production or species conservation.
•In vitro and in vivo fertilization involve sperm collection and handling until gamete co-incubation.•Practical guidelines for sperm handling in fish, penaeid shrimp, bivalve mollusks and marine mammals are presented.•Sperm refrigeration techniques are revised for the different taxa.•Protocols for gamete co-incubation are discussed across the different taxa.
To evaluate the attachment rate of a human embryonic stem cell–derived trophoblastic spheroid onto endometrial epithelial cells in predicting the cumulative live birth rate of an in vitro ...fertilization (IVF) cycle.
A prospective observational study.
University hospital and research laboratory.
A total of 240 infertile women from 2017–2021.
Infertile women with regular cycles attending for IVF were recruited. An endometrial aspirate was collected from a natural cycle 1 month before IVF to determine the BAP-EB attachment rate.
Cumulative live birth rates from a stimulated cycle and its derived frozen embryo transfer cycles within 6 months of ovarian stimulation were obtained.
The BAP-EB attachment rate in women who attained a cumulative live birth was similar to that in those who did not. When women were stratified by age into <35 years and ≥35 years, the BAP-EB attachment rate was significantly higher only in women aged ≥35 years having a live birth when compared with those in the same age group without a live birth. Receiver operating characteristic curve analysis of BAP-EB attachment rate in predicting cumulative live birth showed the areas under the curve of 0.559 (95% confidence interval CI, 0.479–0.639), 0.448 (95% CI, 0.310–0.585), and 0.613 (95% CI, 0.517–0.710) for all ages, an age of <35 years, and an age of ≥35 years, respectively.
The BAP-EB attachment rate offers only a very modest prediction of the cumulative live birth rate in women aged ≥35 years undergoing IVF.
NCT02713854 (https://clinicaltrials.gov/ct2/show/NCT02713854; Date of registration, March 21, 2016; date of enrollment of the first subject, August 1, 2017).
La unión de un esferoide trofoblástico sobre células epiteliales endometriales predice nacidos vivos acumulados en mujeres de 35 años o más
Evaluar la tasa de unión de un esferoide trofoblástico derivado de células madre embrionarias humanas a células del epitelio endometrial en la predicción de la tasa de nacidos vivos acumulada de un ciclo de fertilización in vitro (FIV).
Un estudio observacional prospectivo.
Hospital universitario y laboratorio de investigación.
Un total de 240 mujeres infértiles entre 2017 y 2021.
Se reclutaron mujeres infértiles con ciclos regulares que asistían a FIV. Se recogió un aspirado endometrial de un ciclo natural 1 mes antes de la FIV para determinar la tasa de fijación BAP-EB.
Se obtuvieron las tasas acumuladas de nacidos vivos de un ciclo estimulado y sus ciclos derivados de transferencia de embriones congelados dentro de los 6 meses de la estimulación ovárica.
La tasa de fijación de BAP-EB en mujeres que lograron un nacimiento vivo acumulativo fue similar a la de aquellas que no lo lograron. Cuando las mujeres se estratificaron por edad en <35 años y mayores de 35 años, la tasa de fijación de BAP-EB fue significativamente mayor solo en mujeres mayores o iguales a 35 años con un nacido vivo en comparación con los del mismo grupo de edad sin un nacido vivo. El análisis de la curva característica operativa del receptor de la tasa de fijación de BAP-EB en la predicción de nacidos vivos acumulados mostró áreas bajo la curva de 0,559 (95 % intervalo de confianza IC, 0,479–0,639), 0,448 (IC 95 %, 0,310–0,585) y 0,613 (IC 95 %, 0,517–0,710) para todas las edades, en edad <35 años, y en edad de mayores o iguales a 35 años, respectivamente.
La tasa de fijación de BAP-EB ofrece solo una predicción muy modesta de la tasa acumulada de nacidos vivos en mujeres mayores o iguales a 35 años sometidas a FIV.
To investigate the impact of endometrial receptivity array (ERA) before frozen embryo transfer in patients undergoing in vitro fertilization (IVF). There is a lack of consensus regarding the use of ...ERA for increasing the success rate of IVF cycles, mainly in terms of the live birth rate.
PubMed, Web of Science and Embase were searched from inception up to February 15, 2022.
Not applicable.
Patients undergoing ERA vs no ERA before frozen embryo transfer.
Only comparative studies evaluating pregnancy rates of patients undergoing frozen embryo transfer cycles with or without prior ERA were included. Inter-study heterogeneity was also assessed using Cochrane’s Q test and the I2 statistic. The random-effects model was used to pool the odds ratio (OR) with the corresponding 95% confidence intervals (CIs). Subgroup analyses were performed to investigate the impact of ERA on pregnancy rates according to the number of previous embryo transfer (ET) failures (≤ 2 previous failed ETs vs. > 2 failed ETs, defined as recurrent implantation failure). Separate analyses were performed according to the study design and adjustment for confounders.
The primary outcomes of the study were live birth rate and/or ongoing pregnancy rate. Implantation rate, biochemical pregnancy rate, clinical pregnancy rate, and miscarriage rate were considered secondary outcomes.
Eight studies (representing data on n = 2,784 patients; n = 831 had undergone ERA and n = 1,953 without ERA) were found to be eligible for this meta-analysis. The live birth or ongoing pregnancy rate for the ERA group was not significantly different compared with the non-ERA group (OR, 1.38; 95% CI, 0.79–2.41; I2 83.0%), nor was a difference seen in subgroup analyses based on the number of previous failed ETs. The rates of implantation, biochemical pregnancy, clinical pregnancy, and miscarriage were also comparable between the ERA and the non-ERA groups. After separate analyses according to the study design and adjustment for confounding factors, overall pooled estimates remained statistically nonsignificant.
The findings of the current meta-analysis did not reveal a significant change in the rate of pregnancy after IVF cycles using ERA, and it is not clear whether ERA can increase the pregnancy rate or not.
Prospectively registered in PROSPERO (CRD42022310862).
Test de receptividad endometrial antes de Ciclos de transferencia de embriones congelados: una revisión sistemática y metanálisis.
Investigar el impacto del test de receptividad endometrial (ERA) antes de la transferencia de embrión congelado en pacientes bajo tratamiento de Fecundación in vitro (FIV). Existe una falta de consenso con respecto al uso de la ERA para aumentar la tasa de éxito de los ciclos de FIV, principalmente en términos de la tasa de nacidos vivos.
Se realizaron búsquedas en PubMed, Web de Science y Embase desde su inicio hasta el 15 de febrero de 2022.
No aplicable.
Pacientes sometidos a ERA vs sin ERA antes de la transferencia de embriones congelados.
Sólo estudios comparativos evaluando tasas de embarazo de pacientes sometidas a ciclos de transferencia de embriones congelados con o sin un estudio ERA anterior fueron incluídas. La heterogeneidad entre estudios también se evaluó mediante la prueba Q de Cochrane y la I2 estadística. Se utilizó el modelo de efectos aleatorios para agrupar el odds ratio (OR) con los intervalos de confianza (IC) del 95% correspondientes. Se llevaron a cabo análisis de subgrupos para investigar el impacto de la ERA en las tasas de embarazo de acuerdo con el número de transferencias embrionarias previas (ET) fallidas (≤2 ETs fallidas previos vs. > 2 ETs fallidas, definidos como fallos recurrentes de implantación). Los análisis separados fueron realizados de acuerdo con el diseño del estudio y el ajuste para los factores de confusión.
Los resultados primarios del estudio fueron la tasa de nacidos vivos y/o la tasa de embarazo en curso. Tasa de implantación, la tasa de embarazo bioquímico, la tasa de embarazo clínico y la tasa de aborto espontáneo se consideraron resultados secundarios.
Se encontraron ocho estudios (representando datos sobre n = 2.784 pacientes; n = 831 habían sido sometidos a ERA y n = 1.953 sin ERA) para ser elegibles para este metanálisis. La tasa de nacidos vivos o embarazo en curso para el grupo de ERA no fue significativamente diferente en comparación con el grupo sin ERA (OR, 1,38; IC 95 %, 0,79–2,41; I2 83,0%), tampoco se observó una diferencia en los análisis de subgrupos basados en el número de Transferencias embrionarias fallidas anteriores. Las tasas de implantación, embarazo bioquímico, embarazo clínico y aborto espontáneo también fueron comparables entre los grupos del ERA y los grupos no-ERA. Después de análisis separados según el diseño del estudio y factores de confusión de ajuste las estimaciones, el conjunto total de estimaciones permaneció estadísticamente no significativa.
Los hallazgos del metanálisis actual no revelaron un cambio significativo en la tasa de embarazo después de los ciclos de FIV utilizando ERA, y no está claro si el ERA puede aumentar la tasa de embarazo o no.
In this study, the risk of birth defects was increased with IVF but was no longer significant after adjustment for maternal factors. The risk of birth defects associated with intracytoplasmic sperm ...injection remained higher after multivariate adjustment. Residual confounding cannot be ruled out.
Consistent evidence from individual studies, including registry-based cohort studies
1
,
2
and meta-analyses, has linked assisted conception involving in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with an increased risk of birth defects.
3
–
8
The associations between the use of these techniques and birth defects have appeared to be stronger for singleton births than for multiple births.
9
,
10
It is unclear whether the excess of birth defects after IVF or ICSI may be attributable to patient characteristics related to infertility,
8
rather than to the treatment, and whether the risk is similar across assisted reproductive technologies and related therapies.
3
,
11
, . . .
To determine whether a flexible progestin primed ovarian stimulation (fPPOS) protocol is effective for preventing premature ovulation.
Retrospective cohort study.
Private assisted reproduction ...center.
Eighty-seven oocyte donors and 191 recipients of fresh oocytes.
Each donor was stimulated with a flexible gonadotropin-releasing hormone (GnRH) antagonist protocol in one cycle and with the new fPPOS protocol in the other, within a period of 6 months. FSH was started on cycle day 2–3, and 0.25 mg/day GnRH antagonist or 10 mg/day medroxyprogesterone acetate (MPA) was started on stimulation day 7 or when the leading follicle reached 14 mm, whichever came first.
Duration of stimulation, gonadotropin consumption, duration of GnRH antagonist or MPA administration, number of metaphase II oocytes, and pregnancy rates in fresh oocyte recipients.
Duration of stimulation was 11 (10–11) days in both groups. Total gonadotropin consumption was similar. Pituitary suppression was started on day 7 and lasted for 5 days in each group. There were no premature ovulations in any group. The fPPOS yielded a significantly higher number of cumulus oocyte complexes than GnRH antagonist cycles (33 21–39 vs. 26 18–36, respectively). Likewise, the fPPOS generated significantly more metaphase II oocytes than GnRH antagonist cycles (24 17–34 vs. 21 15–28, respectively). Recipients of fresh oocytes from fPPOS and GnRH antagonist cycles had similar cleavage, blastulation, implantation, and live birth/ongoing pregnancy rates (50% vs. 48.6%).
FPPOS with MPA seems to be an effective choice for preventing premature ovulation in women undergoing ovarian stimulation without compromising oocyte quality.
Comparación de un nuevo protocolo de estimulación ovárica flexible con progesterona con el protocolo con antagonistas de la hormona liberadora de gonadotropinas flexible en técnicas de reproducción asistida
Determinar si un protocolo de estimulación ovárica con progesterona flexible (fPPOS) es efectivo para prevenir la ovulación precoz.
Estudio de cohorte retrospectivo.
Centro privado de reproducción asistida.
87 donantes de ovocitos y 191 receptoras de ovocitos en fresco.
Cada donante fue estimulada con un protocolo flexible de antagonistas de la hormona liberadora de gonadotropinas (GnRH) en un ciclo y con el nuevo protocolo fPPOS en el otro, dentro de un periodo de 6 meses. La FSH se inició en el día 2-3 del ciclo y los 0,25 mg/día de antagonista de la GnRH o 10 mg/día de acetato de medroxiprogesterona (MPA) se iniciaron en el día 7 de estimulación o cuando el folículo mayor alcanzó 14 mm, lo que primero ocurriese.
Duración de la estimulación, consumo de gonadotropinas, duración de la administración del antagonista de la GnRH o de la MPA, número de ovocitos metafase II y tasas de gestación en las receptoras de ovocitos frescos.
La duración de la estimulación fue de 11 (10-11) días en ambos grupos. El consumo total de gonadotropinas fue similar. La supresión hipofisaria se inició en el día 7 y duró 5 días en cada grupo. No hubo ovulaciones precoces en ningún grupo. El fPPOS produjo un número de complejos cúmulo-ovocito significativamente mayor que los ciclos de antagonista de la GnRH (33 21–39 vs. 26 18–36, respectivamente). Así mismo, el fPPOS generó significativamente más ovocitos metafase II que los ciclos de antagonistas de la GnRH (24 17–34 vs. 21 15–28, respectivamente). Las receptoras de ovocitos frescos de fPPOS y de los ciclos de antagonista de la GnRH tuvieron similares tasas de clivaje, blastulación, implantación y de nacido vivo/gestación en curso (50% v. 48,6%).
fPPOS con MPA parece una elección efectiva para prevenir la ovulación precoz en mujeres en estimulación ovárica sin comprometer la calidad ovocitaria.
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