Drug design, development and therapy · 2025
The Follicular Output Rate was Improved with 3-Day Letrozole Administration Compared with 5-Day Letrozole Administration Under Progestin-Primed Ovarian Stimulation.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Wang Xiaoning, Tian Jiarong, Tian Liu, Chen Xin, Zhang Zhenzhen, Diao Honglu, Zhang Ying
Аннотация
PURPOSE: Progestin-primed ovarian stimulation (PPOS) has been widely employed in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. In recent years, letrozole (LE) combined with medroxyprogesterone acetate (MPA) has been used in this protocol to enhance ovarian response. This study compared the effects of a 5-day regimen with those of a 3-day regimen of letrozole within PPOS, focused on the follicular output rate (FORT) and blastocyst formation rates.
PATIENTS AND METHODS: From January 2017 to January 2020, 1,754 infertility patients who received PPOS protocol were divided into two groups: 577 patients received 2.5 mg/day LE for 5 days (LE 5-day), and 1177 patients received the same dose of LE for 3 days (LE 3-day). Propensity score matching (1:1) balanced confounders, yielding 489 patients per group. The primary outcoms was the FORT. The rate of blastocyst formation was evaluated as the secondary outcome. A multivariable logistic regression analysis was performed to compare the disparity in the FORT between the two groups.
RESULTS: After matching, the number of oocytes retrieved, number of mature oocytes, number of blastocysts, blastocyst formation rates, FORT, and clinical pregnancy rates were more favourable in the LE 3-day group than in the LE 5-day group (P < 0.05). In the multivariable linear regression model, after making adjustments for factors such as age, anti-Müllerian hormone (AMH), antral follicle count (AFC), body mass index (BMI), infertility type, and basal P, patients in the LE 3-day group exhibited an increase in the FOTR (β = 0.08, 95% confidence interval [CI] 0.02 to 0.14, P = 0.0082) and blastocyst formation rate (β = 0.23, 95% CI 0.17 to 0.29, P < 0.0001) compared to those in the LE 5-day group.
CONCLUSION: Compared with LE administration for 5 days, LE administration for 3 days may increase the FORT and the rate of blastocyst formation.
PATIENTS AND METHODS: From January 2017 to January 2020, 1,754 infertility patients who received PPOS protocol were divided into two groups: 577 patients received 2.5 mg/day LE for 5 days (LE 5-day), and 1177 patients received the same dose of LE for 3 days (LE 3-day). Propensity score matching (1:1) balanced confounders, yielding 489 patients per group. The primary outcoms was the FORT. The rate of blastocyst formation was evaluated as the secondary outcome. A multivariable logistic regression analysis was performed to compare the disparity in the FORT between the two groups.
RESULTS: After matching, the number of oocytes retrieved, number of mature oocytes, number of blastocysts, blastocyst formation rates, FORT, and clinical pregnancy rates were more favourable in the LE 3-day group than in the LE 5-day group (P < 0.05). In the multivariable linear regression model, after making adjustments for factors such as age, anti-Müllerian hormone (AMH), antral follicle count (AFC), body mass index (BMI), infertility type, and basal P, patients in the LE 3-day group exhibited an increase in the FOTR (β = 0.08, 95% confidence interval [CI] 0.02 to 0.14, P = 0.0082) and blastocyst formation rate (β = 0.23, 95% CI 0.17 to 0.29, P < 0.0001) compared to those in the LE 5-day group.
CONCLUSION: Compared with LE administration for 5 days, LE administration for 3 days may increase the FORT and the rate of blastocyst formation.