Progestin-primed ovarian stimulation: for whom, when and how?

Progestin-primed ovarian stimulation

“…This longer TORI in PPOS cycles (in a range between 33.6 and 39.1 h) was not confirmed in a retrospective study conducted by Ata et al , who observed comparable maturation rates regardless of which protocol the patients had received (PPOS, fPPOS or GnRHant) [16 ▪ ]. Furthermore, existing meta-analyses show no differences in number oocytes and MII oocytes between PPOS and a GnRH analogue [1 ▪▪ ,2 ▪▪ ].…”

“…These data suggest that the trigger to oocyte retrieval interval (TORI) in PPOS cycles should be longer than the usual 36 h adhered to in conventional protocols with GnRH analogues [15]. However, it should be noted that these findings have not been reproduced in humans at the level of steroidogenesis and the study did not include a control group that received GnRH antagonists [2 ▪▪ ].…”

“…fPPOS can also be used in cycles in which GnRHant was initially planned, if freeze-all becomes indicated during OS and prior to initiation of the antagonist [2 ▪▪ ].…”

“…Zhou et al detected a lower CLBR in PGT cycles in NOR and PCOS when PPOS was administered versus GnRHant, while no differences were reported in the DOR group [25]. That said, these data should be viewed with caution given the methodological limitations of the study [2 ▪▪ ]. In addition to the usual limitations associated with retrospective studies, data regarding GnRH agonist triggers and cancelled embryo biopsied were not included.…”

“…Traditionally, gonadotropin-releasing hormone (GnRH) analogs have been employed, with certain disadvantages; for example, injections are administered over several days and costs are high. These drawbacks have fueled an interest in finding alternatives to prevent a premature peak in luteinizing hormone (LH) levels [1 ▪▪ ,2 ▪▪ ].…”