To compare the cumulative live birth rate (CLBR) of the progestin-primed ovarian stimulation (PPOS) protocol with that of the flexible GnRH antagonist protocol in patients with poor prognosis diagnosed per the POSEIDON criteria.

This was a retrospective cohort study. Low-prognosis women who underwent IVF/ICSI at the Reproductive Center of Third Affiliated Hospital of Zhengzhou University between January 2016 and January 2019 were included according to the POSEIDON criteria. The CLBR was the primary outcome of interest. The secondary outcome measures were the numbers of oocytes retrieved, 2PN embryos, available embryos and time to live birth.

A total of 1329 women met the POSEIDON criteria for analysis. For POSEIDON group 1, the dosage of gonadotropin (Gn) was higher in the PPOS group than in the GnRH antagonist group (2757.3 ± 863.1 vs 2419.2 ± 853.1, P=0.01). The CLBR of the PPOS protocols was 54.4%, which was similar to the rate of 53.8% in the GnRH antagonist group. For POSEIDON group 2, the number of available embryos was higher in the PPOS group (2.0 ± 1.7 vs 1.6 ± 1.4, P=0.02) than in the GnRH antagonist group. However, the CLBRs of the two groups were similar (18.1% vs 24.3%, P=0.09). For POSEIDON groups 3 and 4, there were no statistically significant differences in the number of oocytes retrieved, 2PN, available embryos or CLBR between the two protocols. After adjustments for confounding factors, the CLBR remained consistent with the unadjusted rates. In the POSEIDON group 1 population, the GnRH antagonist protocols had a shorter time to live birth (P=0.04).

For low-prognosis patients diagnosed per the POSEIDON criteria, the CLBR of PPOS protocols is comparable to that of GnRH antagonist protocols. In the POSEIDON group 1 population, the GnRH antagonist protocols resulted in a shorter time to live birth.

在根据 POSEIDON 标准诊断为预后不良的患者中，比较孕激素促排卵 (PPOS) 方案与灵活 GnRH 拮抗剂方案的累积活产率 (CLBR)。

这是一项回顾性队列研究。根据 POSEIDON 标准，纳入 2016 年 1 月至 2019 年 1 月期间在郑州大学第三附属医院生殖中心接受 IVF/ICSI 的低预后女性。CLBR 是感兴趣的主要结果。次要结果指标是取回的卵母细胞数量、2PN 胚胎、可用胚胎和活产时间。

共有 1329 名女性符合 POSEIDON 分析标准。对于 POSEIDON 组 1，PPOS 组的促性腺激素 (Gn) 剂量高于 GnRH 拮抗剂组 (2757.3 ± 863.1对比2419.2 ± 853.1，P=0.01）。PPOS 方案的 CLBR 为 54.4%，与 GnRH 拮抗剂组的 53.8% 相似。对于 POSEIDON 组 2，PPOS 组的可用胚胎数量较高（2.0 ± 1.7对比1.6 ± 1.4, P=0.02) 比 GnRH 拮抗剂组高。然而，两组的 CLBR 相似（18.1%对比24.3%，P=0.09）。对于 POSEIDON 第 3 组和第 4 组，两种方案在检索的卵母细胞数量、2PN、可用胚胎或 CLBR 方面没有统计学上的显着差异。在对混杂因素进行调整后，CLBR 与未调整的比率保持一致。在 POSEIDON 第 1 组人群中，GnRH 拮抗剂方案的活产时间较短（P=0.04）。

对于根据 POSEIDON 标准诊断的低预后患者，PPOS 方案的 CLBR 与 GnRH 拮抗剂方案的 CLBR 相当。在 POSEIDON 第 1 组人群中，GnRH 拮抗剂方案可缩短活产时间。