Progestin-primed ovarian stimulation protocol in patients undergoing assisted reproductive technology.

PURPOSE: To evaluate the effectiveness and safety of the novel protocol-progestin-primed ovarian stimulation (PPOS) protocol during controlled ovarian hyperstimulation (COH), in patients undergoing in vitro fertilization/intracytopalsmic sperm injection and embryo transfer (IVF/ICSI-ET).

METHODS

By reviewing and analyzing published studies since PPOS protocol was firstly reported in 2015, we compared differences in ovarian stimulation characteristics, embryological features, pregnancy rates, and neonatal outcomes between PPOS protocol and conventional regimens employed in assisted reproductive technology (ART), and discussed the advantages and limitations of PPOS protocol.

MAIN FINDING: By adding exogenous progestin (P) during early follicular phase, PPOS scheme provide robust control over preovulatory luteinizing hormone (LH) surge and spontaneous ovulation, which promote oocyte maturation and recovery. Compared to various traditional protocols, PPOS achieved promising clinical pregnancy results, and equivalent rates of birth defect and congenital malformation. Moreover, it possessed significantly lower risk of ovarian hyperstimlation syndrome (OHSS).

CONCLUSION

Not inferior or comparable outcomes indicated that PPOS protocol is a competent alternative for ART with no obviously detrimental impact on oocyte development and embryo quality.