A comprehensive evaluation of progestin-primed ovarian stimulation protocol in patients with or without PCOS undergoing in vitro fertilization

Jing Zhu, Jing Zhang, Jing Yang, Dongying Li, Chichiu Wang, Shai E. Elizur, Kanru Zhao, Yanping Kuang*, Yao Wang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Progestin-primed ovarian stimulation (PPOS) regimen was established for assisted reproduction. However, its feasibility and outcomes in polycystic ovary syndrome (PCOS) patients need further evaluation. The outcomes of infertile patients with PCOS (study group) and normal ovaries (control group with unexplained infertility and tubal factor infertility) who underwent PPOS and IVF/ICSI protocol were retrospectively studied. The baseline information, primary, and secondary outcomes of patients were collected. The dynamic changes of hormones were closely monitored. 198 PCOS patients and 374 controls were included in this study. After controlled ovarian hyperstimulation (COH), 15 oocytes were retrieved from PCOS patients on average, which was more than those from the controls (p < 0.001). The oocytes and embryos obtained from the PCOS patients exhibited better developmental potential as the number of fertilized oocytes, cleaved embryos, top-quality embryos, viable embryos, cryopreserved embryos, the rate of fertilization, and viable embryo per oocyte retrieved in PCOS patients were significantly higher than those in the controls (all p < 0.001). No significant difference between the two groups was identified regarding the primary outcome, ongoing pregnancy, and other secondary outcomes. No moderate to severe ovarian hyperstimulation syndrome (OHSS) was diagnosed in either group. With the proposed PPOS protocol, the quantity, quality, developmental potential of oocytes, and embryos obtained from PCOS patients were superior to those from controls. The protocol was efficient and safe in terms of pregnancy, obstetric, and perinatal outcomes. OHSS was effectively mitigated in the patients, with or without PCOS, who underwent COH.

Original languageEnglish
Article number100540
JournalReproductive Biology
Issue number4
StatePublished - Dec 2021


FundersFunder number
9th People's Hospital
Shanghai Jiao University Scientific and Technological Innovation Funds17JCYA01
National Natural Science Foundation of China81503603, 81502232
School of Medicine, Shanghai Jiao Tong UniversityJYLJ2019015
Health and Family Planning Commission of Sichuan Province2014LP010A
Health and Family Planning Commission of Sichuan Province20154Y0183


    • Controlled ovarian hyperstimulation
    • Frozen-thawed embryo transfer
    • GnRH agonist
    • In vitro fertilization
    • Ovarian hyperstimulation syndrome


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