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 15, 2026, 15:57Early Bird Registration Opens for RCOG Female Reproductive Physiology Course – RCOG
-
Jul 15, 2026, 15:53ACOG Joins Coalition to Advance National Women’s Health Strategy – ACOG
-
Jul 15, 2026, 15:44From the Shadow of Pregnancy Loss to a New Pregnancy – RBMO
-
Jul 15, 2026, 15:27Supporting the Launch of the National Strategy to Close the Women’s Health Gap – ASRM
-
Jul 15, 2026, 15:21Sergio Haimovich: AI Is Already Reshaping Scientific Publishing and Disclosure Is Lagging Behind
-
Jul 15, 2026, 15:12The Egg’s Engine Is Fed Plenty of Fuel, It Just Can’t Burn It – Fertility Plus
-
Jul 15, 2026, 15:07Join the Ultrasound in Obstetrics and Gynecology Team as the UOG Social Media Editor – ISUOG
-
Jul 15, 2026, 14:56Can Ultrasound Reliably Detect Residual Cervical Cancer After Conization? – IJGC
-
Jul 15, 2026, 14:27Marco Zaccaria: A Great Webinar, Hosted By BSGE and BMUS