The Progestin-Primed Ovarian Stimulation (PPOS). Progestins instead of GnRH analogues to inhibit spontaneous ovulation during ovarian stimulation: is the beginning of a new era?

Publication date: Available online 29 March 2019Source: Reproductive BioMedicine OnlineAuthor(s): Antonio La Marca, Martina CapuzzoAbstractAdvancements in techniques for freezing oocytes and embryos in the field of assisted reproduction prompted new approaches to ovarian stimulation. A growing attention has been dedicated to progesterone and its derivatives to block the LH surge, since oocyte vitrification permits to remove the concerns about the possible harmful effect of progestins on endometrial receptivity. This review summarizes the state of art in the use of progestins to inhibit ovulation in ovarian stimulation protocols for IVF cycles compared to conventional ovarian stimulation. Progestin primed ovarian stimulation has shown to be effective in inhibiting spontaneous ovulation, without affecting the number of retrieved oocytes and the quality of the embryos obtained. Reproductive outcomes from ovarian stimulation with progestins seem to be similar to those derived from conventional ovarian stimulation, even if large trials are still needed to confirm this aspect. The approach with progestins permits a better control over LH levels, lower costs and an easier administration for the patient by oral assumption. For all these reasons PPOS could be the first choice for ovarian stimulation in fertility preservation, oocyte donation and in preimplantation genetic testing cycles. The so called “non conventional” ovarian stimulation protocols (luteal and random-start, doubl...
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research