Comparison of the effects of Duphaston and Cetrotide on oocyte and embryo quality in women undergoing ICSI: A cross-sectional study

Motaref N, Niloofar Motaref, Sheyda Jouhari, Jouhari S, Mohammadzadeh A, Afsaneh Mohammadzadeh, Somaieh Kazemnejad, Kazemnejad S, Madadi N, Narges Madadi, Sadaf Eghtedari, Eghtedari S, Ghoodjani A, Abolfazl Ghoodjani
International journal of reproductive biomedicine · 2020 · vol. 18(11) , pp. 975–982 · doi:10.18502/ijrm.v13i11.7965 · PMID:33349806 · PMC7749970
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This cross-sectional study found that Duphaston effectively prevents premature luteinizing hormone surges during ICSI and yields significantly more retrieved oocytes than Cetrotide, though embryo quality metrics remained comparable.

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This retrospective cross-sectional study compared the efficacy of oral Duphaston versus injectable Cetrotide for preventing premature luteinizing hormone surges during controlled ovarian hyperstimulation in 200 women undergoing ICSI. The results indicated that Duphaston successfully suppressed LH surges without compromising oocyte maturation or embryo quality, offering a patient-friendly alternative to standard GnRH antagonists with comparable safety profiles. While the study found no significant differences in most clinical outcomes between the two groups, it highlighted that Duphaston is a viable option for cycle management in assisted reproduction. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

BACKGROUND: Premature luteinizing hormone (LH) surge is one of the causes for assisted reproductive technology cycle cancellation, and it is needed to find novel approaches with improved efficacy and safety profile. OBJECTIVE: To compare the effects of Duphaston and Cetrotide on the prevention of premature LH surge and characteristics of retrieved follicles and embryos in women undergoing intracytoplasmic sperm injection. MATERIALS AND METHODS: In this retrospective cross-sectional study, 200 patients who were administrated recombinant follicle-stimulating hormone from the third day of menstruation cycle were included. When the follicular diameter reached above 13-14 mm, Cetrotide was prescribed in the control group, while in the case group, Duphaston was taken orally from the third day of cycle. The retrieved oocytes were fertilized in vitro by intracytoplasmic sperm. The level of hormones on the third day of menstruation and the characteristic of follicles, oocytes, and embryos were compared between the two groups. RESULTS: Duphaston successfully inhibits premature LH surge. There was no significant difference in the level of follicle-stimulating hormone, estradiol, and LH between the case and control groups (p > 0.05). However, results also showed that Duphaston causes more oocyte retrieval in comparison with Cetrotide (p = 0.04). Although, the number of follicles above 14 mm, mature oocyte, and the total number of viable embryos in the case group was slightly higher, it did not reach a significant difference compared with the control group (p > 0.05). CONCLUSION: Duphaston could be used as an appropriate medication instead of gonadotropin-releasing hormone antagonists in women undergoing controlled ovarian hyperstimulation. Duphaston prescription not only prevents premature LH surge but also improves the number of retrieved oocytes.
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Duphaston can be used as an appropriate medication as an alternative to the GnRH antagonists. Duphaston prescription not only prevents premature LH surge but also improves the number of retrieved follicles and their quality. Oral administration of Duphaston provides easy access and better control over LH levels in comparison with the GnRH antagonists. Following the additional investigation about optimum dose and long-term safety of Duphaston, it could be used as a new regimen for a controlled ovarian stimulation in freeze-thaw cycles.

Coi Statement

The authors declare that they have no competing interests.

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