A Randomized Controlled Trial Comparing Medroxyprogesterone Acetate Versus Gnrh Antagonist In Oocyte Donor/Intracytoplasmic Sperm Injection Cycles

Objective: This study compared the efficacy of medroxyprogesterone acetate (MPA) in the oocyte donation cycles to the GnRH antagonist protocol in the prevention of premature LH surge. Methods: This single-blind randomized controlled trial study was performed on 185 oocyte donors between August 2019 and May 2020. Participants were randomized into two groups 91 patients in GnRH antagonist (group A) and 94 patients in MPA (group B). The LH, estradiol, and progesterone blood levels on the day of triggering, the number of dominant follicles, retrieved oocytes, metaphase II (MII) oocytes, embryos, transferred embryos, and clinical pregnancy and live birth were recorded. Results: This study showed that LH levels on the day of triggering had statistically significant differences 0.7 (0.5, 1.15) and 0.99 (0.2, 1.81) in groups A and B, respectively, (P=0.004), However, this difference was not clinically significant. There were no significant differences in the number of MII oocytes and embryos, clinical pregnancy, and live birth rates (P>0.05) between groups. Conclusions: This study showed that to prevent premature LH surge, GnRH antagonist could be replaced by MPA as oral medication which is more cost-effective and feasible for patients with a comparable number of MII oocytes, embryos, clinical pregnancy, and live birth rates. Trail registration: IRCT20081007001306N10