Medroxyprogesterone acetate a viable option for preventing ovulation during IVF

In women undergoing autologous in vitro fertilization (IVF) for fertility treatment, ovulatory suppression with medroxyprogesterone acetate proves effective, with cycle and reproductive outcomes similar to that with gonadotropin-releasing hormone (GnRH) antagonist and the advantage of being cheaper, according to a study.

The study included 418 women (mean age 35.6 years) who underwent a medroxyprogesterone acetate ovarian stimulation protocol during IVF at a single academic-affiliated private fertility practice. Main outcomes including premature ovulation, oocyte and embryo yield, embryo quality, pregnancy rates, and logistical benefits were assessed and compared with those of 419 historical control (mean age 35.7 years) who underwent GnRH cycles.

None of the participants in the medroxyprogesterone acetate group experienced premature ovulation as opposed to five women in the control group (0 percent vs 1.2 percent; risk ratio [RR], 0.09, 95 percent confidence interval [CI], 0.01–1.66). There were no between-group differences observed in the number of oocytes retrieved (14.3 vs 14.3; p=0.83), blastocysts (4.9 vs 5.0; p=0.89), or euploid blastocysts (2.4 vs 2.2; p=0.18).

Clinical pregnancy rate was comparable between the medroxyprogesterone acetate and the control groups (70.4 percent vs 64.2 percent; RR, 0.92, 95 percent CI, 0.72–1.18), as were the length of IVF stimulation and dose of stimulation medications.

Compared with the control, medroxyprogesterone acetate was associated with an average savings of USD 491 on medications, one less monitoring visit (4.4 vs 5.6; p<0.01), and 5.0 fewer injections per cycle.

In an analysis adjusted for age and ovarian reserve, medroxyprogesterone acetate had no effect on having an embryo available for transfer (76.6 percent vs 73.4 percent; adjusted RR, 1.05, 95 percent CI, 0.94–1.14).