{
  "abstract": "Background: Infertile patients with low basal luteinizing hormone (LH) levels have low oocyte retrieval rate, but whether progestin-primed ovarian stimulation (PPOS) protocol with clomiphene citrate (CC) could enhance oocyte retrieval rate in these patients remains unclear.\n\nMethods: This prospective randomized controlled trial was performed between January 2018 and February 2021, included 230 infertile patients with low basal LH levels (LH < 2.27 mIU/mL). In study group, 115 patients received human menopausal gonadotropin (hMG) 150 or 225 IU/d + CC 50 mg/d + medroxyprogesterone acetate (MPA) 10 mg/d from the third day of menstruation. In control group, 115 patients received hMG 150 or 225 IU/d + MPA 10 mg/d from the third day of menstruation. Viable embryos were cryopreserved for later transfer. The primary outcome measure was the oocyte retrieval rate.\n\nResults: CC contributed to LH secretion. The hMG+MPA+CC group showed a decreased oocyte retrieval rate (0.71 ± 0.22 vs. 0.76 ± 0.18, mean difference (MD) -0.06 (-0.11 to -0.01); P = 0.043) and a decreased number of cryopreserved embryos (2.89 ± 2.43 vs. 3.90 ± 2.39, MD -0.89 (-1.50 to -0.28); FDR-P = 0.035). Two groups had similar number of retrieved oocytes (8.83 ± 5.41 vs. 10.69 ± 5.85, MD -0.99 (-2.27 to 0.29); FDR-P = 0.213) and oocyte utilization rate (0.40 ± 0.25 vs. 0.46 ± 0.24, MD -0.07 (-0.14 to -0.01); FDR-P = 0.084). Two groups had comparable cumulative clinical pregnancy rates (61.05% vs. 77.67%, hazard ratio (HR) 0.74 (0.53 to 1.06); P = 0.101; FDR-P = 0.214) and cumulative live birth rates (53.68% vs. 66.02%, HR 0.77 (0.53 to 1.13); P = 0.183; FDR-P = 0.214).\n\nConclusions: CC contributed to LH secretion, but PPOS protocol with CC resulted in a lower oocyte retrieval rate in patients with low basal LH levels. PPOS protocol with CC should be used cautiously in these patients.\n\nTrial registration: ChiCTR number: ChiCTR1800014440. URL: https://www.chictr.org.cn/showproj.html?proj=24573. Date of registration: 2018/01/13. Date of enrollment of the first subject: 2018/1/17.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Rd, Shanghai, 200011 China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhijie Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yong Fan"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaoqian Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Haiyan Guo"
    },
    {
      "affs": [
        0
      ],
      "name": "Weiran Chai"
    },
    {
      "affs": [
        0
      ],
      "name": "Qiuju Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Qifeng Lyu",
      "orcid": "0000-0002-9885-6522"
    },
    {
      "affs": [
        0
      ],
      "name": "Renfei Cai",
      "orcid": "0000-0001-9273-5570"
    },
    {
      "affs": [
        0
      ],
      "name": "Xuefeng Lu",
      "orcid": "0000-0002-8058-9630"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3xkfma8m87a50.bib",
  "cited_by": 0,
  "doi": "10.1186/s12958-026-01601-5",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13729595/",
  "id": "3xkfma8m87a50",
  "issns": [
    "1477-7827"
  ],
  "landing_url": "https://doi.org/10.1186/s12958-026-01601-5",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2743|Reproductive Biology and Fertility"
    ]
  ],
  "openalex": "W7197038108",
  "pdf_url": null,
  "pmcid": "PMC13729595",
  "pmid": "42978013",
  "published": "2026-08-06",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/3xkfma8m87a50.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:19Z",
      "native_id": "PMC13729595",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12958-026-01601-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2743|Reproductive Biology and Fertility",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Effects of progestin-primed ovarian stimulation protocol plus clomiphene citrate in patients with low basal LH levels: a randomized controlled trial",
  "title_text": "Effects of progestin-primed ovarian stimulation protocol plus clomiphene citrate in patients with low basal LH levels: a randomized controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:19Z",
  "url": "https://research.draconitic.com/paper/3xkfma8m87a50",
  "venue": "Reproductive Biology and Endocrinology : RB&E",
  "versions": []
}