ArticleReproductive biology and endocrinology : RB&E2023
Progestin Primed Ovarian Stimulation (PPOS) protocol yields lower euploidy rate in older patients undergoing IVF.
Article in Reproductive biology and endocrinology : RB&E, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Progestin-primed ovarian stimulation (PPOS) in preimplantation genetic testing for aneuploidy: a retrospective study and meta-analysis.Archives of gynecology and obstetrics · 2025Pooled it
- Impact of the PPOS protocol on euploidy embryo rates and reproductive outcomes in preimplantation genetic testing cycles: a systematic review.Frontiers in endocrinology · 2025Pooled it
- Comparison of the euploidy rate in preimplantation genetic testing for aneuploidy cycles following progestin-primed versus gonadotropin-releasing hormone antagonist protocol: a randomized controlled study.Reproductive biology and endocrinology : RB&E · 2025Trial
- Comparison of progesterone protocol versus gonadotropin-releasing hormone antagonist protocol in terms of preventing premature LH surge and assisted reproductive technology outcome in infertile women: a randomized controlled trial.Archives of gynecology and obstetrics · 2024Trial
- Article
- Evaluating progestin-primed and GnRH antagonist ovarian stimulation protocols in PGT-A cycles: implications for clinical practice.BMC pregnancy and childbirth · 2026Article
- Flexible progestin-primed ovarian stimulation is a safe and effective alternative to GnRH antagonist protocol in PGT-A cycles.Turkish journal of obstetrics and gynecology · 2026Article
- Impact of GnRH antagonist protocols versus progestin-primed ovarian stimulation on reproductive outcomes in advanced reproductive age women: a propensity score-matched retrospective cohort study.Frontiers in endocrinology · 2026Article
- Modified clomiphene citrate protocol versus gonadotropin-releasing hormone antagonist protocol inFrontiers in endocrinology · 2026Article
- Comparing the euploidy rate between the progestin-primed and gonadotrophin-releasing hormone antagonist protocols in preimplantation genetic testing for aneuploidy: a randomized controlled trial.Human reproduction open · 2026Article
- Luteal-phase stimulation does not compromise embryo euploidy or live birth outcomes compared to follicular-phase stimulation.Frontiers in medicine · 2026Article
- Clinical outcomes following GnRH antagonist protocol change to PPOS protocol versus GnRH antagonist protocol in patients with pre-elevated progesterone: a propensity score matching study.Journal of ovarian research · 2025Article
- Age-stratified analysis of euploidy rates in Progestin-Primed Ovarian Stimulation (PPOS) utilizing micronized progesterone or dydrogesterone versus GnRH analogues.Journal of ovarian research · 2025Article
- Three different protocols for pituitary suppression: progestins (dydrogesterone or medroxyprogesterone acetate) versus GnRH antagonist-balancing efficacy and cost in ovarian stimulation.Journal of assisted reproduction and genetics · 2025Article
- Analysis of cumulative live birth rate outcomes of four ovarian stimulation protocols in Poseidon groups 3/4 patients with adenomyosis.Journal of assisted reproduction and genetics · 2025Article
- Euploidy rate and pregnancy outcomes in preimplantation genetic testing for aneuploidy cycles using progestin-primed ovarian stimulation versus GnRH antagonist protocol.Reproductive biology and endocrinology : RB&E · 2025Article
- Article
- Cell-free fat extract improves embryo development and clinical outcomes in older women with previous in-vitro fertilization failure.Reproductive biology and endocrinology : RB&E · 2025Article
- Factors influencing oocyte yield and embryo quality in donor IVF cycles: a retrospective cohort study.Frontiers in endocrinology · 2025Article
- A multicycle approach through DuoStim with a progestin-primed ovarian stimulation (PPOS) protocol: a valuable option in poor prognosis patients undergoing PGT-A.Journal of assisted reproduction and genetics · 2025Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo explore if exogenous progestin required for progestin primed ovarian stimulation (PPOS) protocol compromises the euploidy rate of patients who underwent preimplantation genetic testing cycles when compared to those who received the conventional gonadotropin-releasing hormone (GnRH) antagonist protocol.
methodsThis retrospective cohort study analyzed 128 preimplantation genetic testing for aneuploidy (PGT-A) cycles performed from January 2018 to December 2021 in a single university hospital-affiliated fertility center. Infertile women aged 27 to 45 years old requiring PGT-A underwent either PPOS protocol or GnRH-antagonist protocol with in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) for fertilization. Frozen embryo transfers were performed following each PGT-A cycle. Data regarding the two groups were analyzed using the Statistical Package for Social Sciences (SPSS) version 22.0 (SPSS Inc., Chicago, IL).
resultsPatients who underwent PPOS treatment had significantly reduced blastocyst formation rate and euploidy rate compared to those who received the GnRH antagonist protocol. Subgroup-analysis was performed by stratifying patients' age into elder and young subgroups (elder: ≥ 38-year-old, young: < 38-year-old). In the elder sub-population, the blastocyst formation rate of the PPOS group was significantly lower than that of the GnRH-antagonist group (45.8 ± 6.1% vs. 59.9 ± 3.8%, p = 0.036). Moreover, the euploidy rate of the PPOS group was only about 20% of that of the GnRH-antagonist group (5.4% and 26.7%, p = 0.006). In contrast, no significant differences in blastocyst formation rate (63.5 ± 5.7% vs. 67.1 ± 3.2%, p = 0.45) or euploidy rate (30.1% vs. 38.5%, p = 0.221) were observed in the young sub-population. Secondary outcomes, which included implantation rate, biochemical pregnancy rate, clinical pregnancy rate, live birth rate, and miscarriage rate, were comparable between the two treatment groups, regardless of age.
conclusionWhen compared to the conventional GnRH-antagonist approach, PPOS protocol could potentially reduce the euploidy rate in aging IVF patients. However, due to the retrospective nature of this study, the results are to be interpreted with caution. Before the PPOS protocol is widely implemented, further studies exploring its efficacy in larger populations are needed to define the optimal patient selection suitable for this method.
trial registrationHuman Investigation and Ethical Committee of Chang Gung Medical Foundation (202200194B0).
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