A randomized study comparing flexible PPOS with flexible GnRH antagonist protocol in IVF outcomes
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20262091Keywords:
ART, Flexible PPOS, Flexible GnRH antagonist, NormorespondersAbstract
Background: To compare clinical efficacy of flexible PPOS and flexible GnRH antagonist protocol in ART.
Methods: A prospective randomized controlled study was conducted at RIDGE IVF Centre, Delhi, from July 2024 to June 2025. 100 women with normal ovarian reserve, aged 21–40 years, undergoing IVF/ICSI were randomly assigned to Group A (fPPOS, n=50) or Group B (flexible GnRH antagonist, n=50). Primary outcomes were number of oocytes retrieved, mature oocytes (MII), embryo formation, embryo quality on day 3 and day 5. Gonadotropin dosage, stimulation duration and clinical pregnancy rates were secondary outcomes.
Results: The two groups shared comparable baseline characteristics, including age, BMI, type of infertility and infertility duration. Although day 2 FSH levels were lower in Group A, serum AMH and AFC levels were comparable in both groups. The number of oocytes retrieved, MII oocytes and embryos formed were comparable (p>0.05). In either protocol, there were no instances of premature luteinization. On day 3 and day 5, neither the quality/distribution of the embryos differed significantly (p>0.05). Both groups had comparable clinical pregnancy rates (p=1.0) and β-hCG positivity rates (50 percent vs. 42 percent, p=0.42). There were no significant differences in duration of stimulation or total dose of gonadotropin used. No cases of OHSS were reported.
Conclusions: In IVF cycles, flexible PPOS and flexible GnRH antagonist protocols have comparable clinical and embryological outcomes. Flexible PPOS is a viable, patient-friendly alternative for frozen- embryo transfer cycles.
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