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Objective: To compare the clinical outcomes and cost‐effectiveness of progestin‐primed ovarian stimulation (PPOS) and the gonadotropin‐releasing hormone‐antagonist (GnRH‐A) protocol in fertility preservation (FP) in cancer patients. The stimulation option when patients were in the luteal phase was also explored. Methods: This retrospective study analyzed clinical data from 163 patients who underwent FP. The number of retrieved oocytes and vitrified oocytes/embryos, total dose of gonadotropin, duration of stimulation, number of injections, and cost were compared among the PPOS, GnRH‐A, and luteal phase stimulation (LPS) groups. Results: No significant differences were noted in the numbers of retrieved oocytes and vitrified oocytes/embryos among the three groups. In the multiple regression model, age (P = 0.02) and antral follicle count (AFC) (P < 0.001), but not the controlled ovarian stimulation (COS) protocols (P = 0.586), were associated with the number of retrieved oocytes. The number of injections and the cost were all significantly lower in the PPOS and LPS groups than in the GnRH‐A group(P < 0.001). Conclusion: PPOS had similar clinical results but was superior medically and economically to GnRH‐A. For patients in the luteal phase, LPS was an optional protocol with similar outcomes and costs to PPOS. Synopsis: PPOS protocols had similar clinical but superior medico‐economic to GnRH‐A. LPS was an optional protocol with similar outcomes and costs as PPOS. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare two embryo culture strategies in older women with four or fewer D3 embryos. A total of 556 eligible patients aged >38 years in a single reproductive centre underwent IVF/ICSI leading to the generation of four or fewer D3 embryos from April 2016 to October 2018. Patients whose D3 embryos were all cultured to blastocyst were classified as group A; those in which none of their embryos was cultured to blastocysts were classified as group B. Cumulative biochemical pregnancy rate, clinical pregnancy rate and live birth rate were similar between the two groups (p = 0.582, 0.426 and 0.546, respectively). Though more embryo transfer cycles were achieved in group B, significantly higher biochemical and clinical pregnancy rate per embryo transfer cycle were found in group A (p = 0.001 and 0.003). In patients with blastocyst culture, the clinical conditions of those who had a successful outcome were better than those who failed. Blastocyst culture and transfer can significantly increase pregnancy rate per embryo transfer cycle and may be appropriate in some older patients with a good clinical prognosis. [ABSTRACT FROM AUTHOR]