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GnRH antagonist protocol is currently a good strategy for controlled ovarian stimulation in women with PCOS undergoing IVF/ICSI cycles. Finding a protocol that can be a better alternative will help in improving the success rate of IVF/ICSI cycles
Progesterone has potent restraint on hypothalamus-pituitary-ovarian axis. It acts on unidentified hypothalamic pulse oscillator neurons. In turn, it acts on gonadotropins releasing hormone (GnRH) secreting neurons leading to inhibition of GnRH secretion. This results in inhibition of both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion from anterior pituitary. The effect of progesterone appears to decrease GnRH pulse frequency which results in slowing down LH pulse frequency and reducing LH plasma concentrations
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group (A) | Experimental | will be subjected to progestin primed ovarian stimulation protocol Women in group (A), will be prescribed 20 mg oral dose of dydrogesterone (Duphaston, Abbott) from the 2nd day of the cycle and continued until the trigger day. Transvaginal follicular monitoring will be done for all patients starting the 6th day of cycle. |
|
| group (B) | Active Comparator | Gonadotropin Releasing Hormone Antagonist Protocol when the size of dominant follicles reaches 12-13 mm, 0.25 mg of cetrotide (Merck-Serono Germany) will be injected subcutaneously daily and continued until the day of trigger shot. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| progestin primed ovarian stimulation protocol | Other | progestin primed ovarian stimulation protocol |
|
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy (Number of MII oocytes retrieved) | this outcome means to measure Percentage (number) of MII oocytes retrieved During our study | 3 months |
| Efficacy (Maturation index) | Maturation index will be calculated: Rate of metaphase-II oocytes (MII) to total oocytes | 3 months |
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Inclusion Criteria:
Exclusion Criteria:
20-40 years
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| mostafa fahmy, mcs | Contact | 01065644434 | mafahmy21@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| mostafa fahmy, mcs | zagazig | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zagazig University | Recruiting | Zagazig | 44511 | Egypt |
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| dydrogesterone (Duphaston, Abbott) | Drug | 20 mg oral dose of dydrogesterone (Duphaston, Abbott) |
|
| Cetrotide | Drug | 0.25 mg of Cetrotide (gonadotropin releasing hormone (GnRH) antagonist) |
|
|
| ID | Term |
|---|---|
| D010048 | Ovarian Cysts |
| D007246 | Infertility |
| ID | Term |
|---|---|
| D003560 | Cysts |
| D009369 | Neoplasms |
| D010049 | Ovarian Diseases |
| D000291 | Adnexal Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D004394 | Dydrogesterone |
| C062876 | cetrorelix |
| ID | Term |
|---|---|
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
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