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

Purpose: 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.