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REVIEW ARTICLE
Year : 2022  |  Volume : 9  |  Issue : 1  |  Page : 16-22

Progestin primed ovarian stimulation protocol: current status in assisted reproductive technology


1 Department of Reproductive Medicine, Lilavati Hospital & Research Center, Mumbai, India
2 Lilavati Hospital Mumbai and Fortis Hospital Delhi, Mohali, Gurugram; Bloom IVF, India
3 Lilavati Hospital Mumbai and Jaslok Hospital Mumbai; Bloom IVF, India

Correspondence Address:
MBBS, MS, DNB, FNB Rashmi Baid
Department of Reproductive Medicine, Bloom IVF, Lilavati Hospital & Research Center, Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/fsr.fsr_48_21

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Progestin primed ovarian stimulation (PPOS) is a novel controlled ovarian stimulation protocol. Prevention of endogenous luteinizing hormone surge is an important step in assisted reproductive technology cycles. Gonadotropin-releasing hormone (GnRH) analogs are used conventionally for preventing premature ovulation before egg retrieval. However, GnRH analogs – both agonists and antagonists – have certain disadvantages such as increased cost, the requirement of daily injections, patient inconvenience, and adverse effects, which have prompted us to search for possible alternatives. Oral progesterone has been used recently as an effective alternative to GnRH analogs. Although the use of progestin requires mandatory cryopreservation of all the embryos due to embryo-endometrium asynchrony, advances in freezing techniques have rendered it feasible. Moreover, progestin is cost-effective, administered orally, convenient, and easily accessible. Hence, this new PPOS protocol combined with freeze-all cycles is an effective alternative to GnRH analogs for pituitary suppression during ovarian stimulation. This review aims to evaluate the current status of the PPOS protocol, its mechanism, different regimes, advantages, and disadvantages.


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