Dydrogesterone Primed Ovarian Stimulation is a Novel, Effective and Low-cost Protocol for Fertility Preservation

Introduction:
Progestin primed ovarian stimulation (PPOS) was first suggested in freeze all cycles. Progestin oral products effectively prevent LH surge, cheap and allow ovulation triggering with GnRH agonist. Different progestin rehgimens were examined with similar outcomes, Dydrogesterone (Duphaston) is a synthetic progestin, that cannot be detected in blood, unlike natural progestin that might rise confusion regarding luteinization. For that, PPOS with Dydrogesterone is a good and cheaper alternative for fertility preservation.

Aim of Study:
To compare fertility preservation cycles outcomes of Dydrogesterone PPOS compared to antagonist in fertility preservation cycles.

Methods:
A retrospective study, collecting data from digital files of oocyte and embryo cryopreservation cycles for medical and social fertility preservation, aged18-41years, between January to October 2021.In PPOS cycles 10 mg of Dydrogesterone three times a day were administered in early follicular phase with Gonadotropins.

Results:
It is an interim analysis, we collected data of 380 (87.76%) antagonist and 53 (12.24%) Dydrogesterone cycles,52 medical and 368 social fertility preservation and 13 transgender cases. Out of medical indication 84.62% were antagonist and 15.38% combined,while social 87.77% antagonist and 12.23 %were combined, all of transgender cycles were antagonist. We found no difference in number of oocytes retrieved (mean 16.08 vs. 16.47) and number of mature oocytes – MII (12.14 vs. 13.15) and MII rate (75.18% vs. 79.68%) in antagonist cycles vs. Dydrogesterin cycles,respectively.

Conclusion:
These results encourage the use of PPOS Dydrogesterone protocol in fertility preservation as it shows comparable results and much lower costs increasing accessibility, especially to social egg freezing.