Desogestrel versus antagonist injections for LH suppression in oocyte donation cycles: a crossover study

To study whether ovarian response to corifollitropin among oocyte donors (OD) is different when oral desogestrel (DSG) is used to block the luteinizing hormone (LH) surge when compared to GnRH-antagonist use. This is a retrospective, cohort study at a private, university-based, IVF center including 35 OD. Patients underwent two stimulation cycles under corifollitropin alfa (CFT), one under an antagonist and another under DSG, between February 2015 and May 2017. In antagonist cycles, daily ganirelix was administered since a leading follicle reached 14 mm. In the DSG cycles, daily oral DSG was prescribed. The main outcome measure was oocytes retrieved. Compared to antagonist cycles, cycles under DSG received fewer injections (10.3 +/- 2.8 vs. 5.0 +/- 2.1, p<.001), nominally lower total supplementary gonadotropin dose (497.4 +/- 338.9I U vs. 442.9 +/- 332.8 IU, p=.45) with a lower total cost of medication (1018.6 +/- 191.0(sic) vs. 813.8 +/- 145.9(sic), p<.001). There were no differences in the total number of retrieved oocytes between groups (17.4 +/- 7.5 vs. 18.6 +/- 8.9, p=.34). In the corresponding oocyte recipients, clinical pregnancy rate was similar between groups: 52.0% vs. 58.6%, respectively (p=.78). ODs' stimulation's response under DSG is similar when compared to (17.4 +/- 7.5 vs. 18.6 +/- 8.9, p=.34) but associated with less injections and lower medication costs. The main advantage of this strategy is its simplicity, an aspect of utmost importance in the management of ODs.