JBRA Assist. Reprod. 2025;29(Suppl 1):19-19
POSTER PRESENTATION
doi: 10.5935/1518-0557.20250074
1Centro de Esterilidad Montevideo
Objective: Progestin-primed ovarian stimulation (PPOS) is a modern approach used in assisted reproduction, based on the ability of progesterone to inhibit ovulation. PPOS has been used as an efficient alternative to GnRH analog antagonists to suppress LH secretion and prevent an endogenous LH peak. Progestins have proven their effectiveness as gonadotropin adjuvants in terms of ovarian response, reproductive outcomes, and safety. In addition, they offer the convenience of oral administration and a lower cost than GnRH analogs. Evidence supports PPOS as a more patient-friendly approach to ovarian stimulation, especially when frozen embryo transfer or oocyte preservation is planned. Given the implications on oocyte maturation and retrieval of replacing injectable gonadotropin-releasing hormone antagonists, the aim of this study is to evaluate the effectiveness of oral progesterone to inhibit increases in luteinizing hormone in our patients.
Methods: Retrospective, single center study performed from October 2023 to March 2025. Women who underwent stimulation cycles as oocyte donors and for social and medical fertility preservation (PF) were included. Micronized progesterone 200 mg was administered orally once daily from the initiation of gonadotropin stimulation until the day of the trigger. Data was obtained from medical records. We recorded the number of retrieved and Metaphase II oocytes (MII oocytes). The impact of oral progesterone in early ovulation was analyzed. All analyses were conducted using jupyter-notebooks, with python 3.6 as the main tool for the development of descriptive statistics. A p value <0.05 was considered significant.
Results: A total of 104 patients were included. Mean age was 32.9 (17 to 44), mean body mass index was 22.9 (18.3 to 43.2). 8% of women were oocyte donors, 63% medical PF, 28% social PF. 2 patients had 0 oocytes in the retrieval (1,9% of the sample). The mean number of retrieved oocytes was 12, and the mean number of MII oocytes was 10, with a mean mature oocyte rate of 80.7%.
Conclusion: The PPOS protocol with orally administered micronized progesterone is an effective alternative for ovarian stimulation in terms of oocyte retrieval and maturation. Furthermore, its oral administration makes it a more patient-friendly and cost-effective option compared to GnRH antagonists, especially when planning a frozen embryo transfer or oocyte preservation.