Application Effect Of Progestin-primed Ovarian Stimulation And Micro-stimulation Protocol For Patients With Poor Ovarianresponse In Vitro Fertilization And Embryo Transfer(IVF-ET) Treatment

Objective: To compare the efficacy of progestin-primed ovarian stimulation and micro-stimulation protocol for patients with poor ovarian response who underwent in vitro fertilization and embryo transfer(IVF-ET)treatmentMethods: The Pub Med,Medline,CBM,CNKI and Wanfang Databases were electronically searched from established to May 2018.Extraction of original data were performed according to NORS and Cochrane system evaluation method,and Meta analysis was carried out with Rev Man 5.2software.Results: A total of 4733 cycles from 11 researches were recruited in this study,including PPOS group(2270 cycles)and micro-stimulation group(2463cycles).The results of meta-analysis showed that there was no statistical difference in the number of obtained embryos [WMD=0.03,95% CI(-0.37,0.42),P=0.89],transferable embryos [WMD=0.17,95% CI(-0.10,0.43),P=0.22] and clinical pregnancy rate [OR=1.09,95% CI(0,79,1.50),P=0.59].However,the good quality embryo rate was higher [OR=1.82,95%CI(1.48,2.23),P<0.00001]and the cycle cancellation rate was lower[OR=0.57,95%CI(0.46,0.70),P<0.0001]in PPOS group than that in micro-stimulation group respectively.The funnel graph shows that the probability of publication bias is low.Conclusion: The current available evidence suggests that progestin-primed ovarian stimulation can improve the good quality embryo rate and reduce the cycle cancellation rate for patients with poor ovarian response.However,the above conclusions still need to be confirmed by multi-center,large-sample randomized controlled trials.