Ovarian stimulation with progestin in IVF programs with donor eggs
Diana Martirosyan1, Eduard Hambartsoumian1,2
1 Fertility Center
2 National Institute of Health of Armenia. Department Human Reproduction (Yerevan, Armenia)
Abstract
The Progestin-Primed Ovarian Stimulation (PPOS) protocol is one of the modern ovarian stimulation schemes in assisted reproductive technologies (ART). The main goal of PPOS is to prevent premature luteinizing hormone (LH) surges during ovarian stimulation, achieved by using progestins instead of traditional gonadotropin-releasing hormone (GnRH) antagonists. PPOS is used both for standard IVF cycles and for egg donation programs. In our study, it was shown that this protocol provides high results in terms of the number and quality of mature oocytes. We studied the dynamics of LH, E2, and P4 hormone levels during ovarian stimulation in the population of egg donors. The results of our research showed that progestins are an effective means of preventing premature LH surges. We also found that progestins not only prevent LH surges on the preovulatory days of ovarian stimulation but also significantly reduce both LH and P4 levels (p<0.05). Furthermore, the use of progestins in IVF and egg donation programs does not reduce embryological indicators after ovarian puncture, as evidenced by high fertilization rates (74%) and blastulation rates (61%). Additional advantages of PPOS include the low cost of progestins, and patients do not require daily injections of GnRH antagonists, improving convenience and comfort. Thus, the PPOS protocol is an effective and safe alternative to traditional ovarian stimulation schemes in egg donation and IVF programs.