P-237 Does PPOS improve oocyte yield at the cost of DNA Integrity? Clinical implications from a comparative study with the antagonist protocol
Notice bibliographique
Résumé
Abstract Study question Does PPOS lead to higher oocyte yield and euploid conversion rates compared to the antagonist protocol, and does it compromise oocyte DNA integrity? Summary answer PPOS increases mature oocyte yield and euploid conversion rates per oocyte, but higher segmental aneuploidy rates raise concerns about potential DNA damage, warranting further investigation. What is known already Progestin-Primed Ovarian Stimulation (PPOS) is a viable alternative to antagonist protocols, offering cycle scheduling flexibility with comparable pregnancy outcomes. While some studies suggest similar embryological outcomes, limited data exist on oocyte quality, euploid conversion efficiency, and potential DNA damage. Understanding whether PPOS enhances oocyte retrieval while preserving DNA integrity is critical for optimizing individualized ovarian stimulation protocols. Study design, size, duration This retrospective cohort study was conducted at Ovo Clinic, a university-affiliated private fertility center in Montreal, Canada, analyzing 449 IVF with PGT-A cycles performed in 2023 and 2024, comparing 24 PPOS cycles with 425 antagonist cycles under the same laboratory and clinical conditions. Participants/materials, setting, methods Patients were categorized into PPOS (n = 24) and antagonist (n = 425) groups. Parameters assessed included baseline age, AMH, mature oocyte yield, euploid embryo rates, and aneuploidy rates. Quantitative variables were compared using parametric or non-parametric test depending on their distribution. Qualitative variables were assessed using the chi-square or Fisher’s exact test. A p-value < 0.05 was considered statistically significant. Main results and the role of chance Baseline characteristics were comparable between groups (age: 37.7 ± 2.9 vs. 37.7 ± 3.7 years, p = 0.48; AMH: 3.4 ± 2.7 vs. 3.1 ± 2.7 ng/mL, p = 0.56). PPOS yielded more mature oocytes (16.0 ± 12.4 vs. 11.8 ± 6.8, p = 0.18) and demonstrated a significantly higher euploid conversion rate per mature oocyte (29.8% vs. 12.6%, p < 0.001). Although euploid embryo rates per embryo were similar (44.7% vs. 44.1%, p = 0.92), segmental aneuploidy rates were significantly higher in the PPOS group (6.1% vs. 0.8%, p < 0.001). These findings suggest that while PPOS may improve oocyte retrieval efficiency, concerns remain regarding its potential impact on oocyte DNA integrity. One hypothesis to explore is whether oxidative stress induced by the PPOS protocol contributes to DNA damage, leading to increased segmental aneuploidies. Future studies should assess oxidative stress markers and DNA fragmentation in oocytes to determine if this mechanism is clinically relevant. Limitations, reasons for caution The small sample size in the PPOS group limits statistical power. As this is an exploratory study, larger, prospective trials with oxidative stress assessments are needed. Wider implications of the findings PPOS appears beneficial for patients requiring higher oocyte yields, but potential risks to DNA integrity must be considered. Future studies should refine patient selection criteria for its use. Trial registration number No
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».