Taarika Ramesh: Rethinking IVF Stimulation With Progestin-Primed Protocols
Taarika Ramesh, Junior Resident at Vardhman Mahavir Medical College, shared a post on LinkedIn:
“When Progesterone Leads the Protocol: Rethinking Ovarian Stimulation in IVF
The Progestin Primed Ovarian Stimulation (PPOS) approach is quietly reshaping how we manage controlled ovarian stimulation.
Traditionally, preventing premature LH surge meant relying on GnRH analogues. But PPOS challenges that paradigm by using oral progestins to achieve the same goal, with surprising efficiency.
How it works:
Progestins suppress the HPO axis, effectively preventing premature LH surge during stimulation, without the need for GnRH antagonists.
Why it matters:
- Simplifies protocols (oral medication, fewer injections)
- Cost-effective alternative in resource conscious settings
- Particularly useful in poor responders and fertility preservation cycles
- Aligns well with a freeze-all strategy.
Protocol Snapshot:
Day 2–3:
- Start Gonadotropins
- + Oral progestin
Monitoring → TVS + E2
Trigger → GnRH agonist / hCG
OPU → Freeze all embryos
Limitations:
Endometrial advancement under progesterone makes fresh embryo transfer unsuitable ,making vitrification essential.
Emerging perspective:
With advancements in cryopreservation, especially vitrification, the ‘freeze-all’ strategy is no longer a limitation,but a strategic advantage.
Clinical takeaway:
PPOS is not just an alternative but a paradigm shift in selected IVF populations, emphasizing flexibility, patient comfort, and individualized care.”
Stay updated on all scientific advances in the field of fertility with Fertility News.
-
Jul 10, 2026, 15:05Marco Zaccaria: Masterclass Organized by MSEC On The Basics of Hysteroscopy
-
Jul 10, 2026, 14:50The Prevention of Group B Streptococcal Disease in Perinatal Period – RCOG
-
Jul 10, 2026, 14:24Christopher Robinson: Myometrial Marking to Improve Suturing of the Uterine Incision at Cesarean Delivery
-
Jul 10, 2026, 13:28Emad Sedeek: PGT-A Is a Diagnostic Tool, Not a Guaranteed Pathway to Higher IVF Success
-
Jul 10, 2026, 13:10Nimra Zulfiqar: RCT Finds Dinoprostone–Laminaria Combination Reduces Cesarean Deliveries During Labor Induction
-
Jul 9, 2026, 18:08Camille A. Clare and Willie Underwood Ill Highlight Coding Changes for Every Stage of Pregnancy – ACOG
-
Jul 9, 2026, 15:53Practical Advice to Help Pregnant Women Stay Safe During Periods of Extreme Heat – FIGO
-
Jul 9, 2026, 15:42Serum Estradiol Decline Before Ovulatory Trigger and ART Outcomes – Fertility and Sterility
-
Jul 9, 2026, 15:36PGT-A Is Associated with a Reduced Live Birth Rate in Routine Practice – RBMO