Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control study
Abstract Background The PPOS (Progestin Primed Ovarian Stimulation) protocol has been evaluated and has proved its effectiveness in preventing the LH (luteinizing hormone) surge. This protocol is often used for cryopreservation for social reasons because it is simpler and more cost-effective. The ob...
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BMC
2025-05-01
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| Series: | Reproductive Biology and Endocrinology |
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| Online Access: | https://doi.org/10.1186/s12958-025-01402-2 |
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| author | Ophélie Sounigo Léah Cohen Aloro Michael Grynberg Céleste Becquart Maxence Majer Vincent Puy Christophe Sifer Claire Vinolas Florence Eustache Laetita Hesters Anne Mayeur Isabelle Cedrin-Durnerin Charlotte Sonigo Maeliss Peigné |
| author_facet | Ophélie Sounigo Léah Cohen Aloro Michael Grynberg Céleste Becquart Maxence Majer Vincent Puy Christophe Sifer Claire Vinolas Florence Eustache Laetita Hesters Anne Mayeur Isabelle Cedrin-Durnerin Charlotte Sonigo Maeliss Peigné |
| author_sort | Ophélie Sounigo |
| collection | DOAJ |
| description | Abstract Background The PPOS (Progestin Primed Ovarian Stimulation) protocol has been evaluated and has proved its effectiveness in preventing the LH (luteinizing hormone) surge. This protocol is often used for cryopreservation for social reasons because it is simpler and more cost-effective. The objective of our study was to evaluate the efficacy and the convenience of the PPOS protocol in the context of oocyte cryopreservation for social reasons. Methods In this bicentric matched case‒control study, all PPOS cycles performed for nonmedical reasons between January 2021 and June 2023 were included. Each PPOS cycle was matched with 2 control cycles performed with the antagonist protocol on the basis of the antral follicle count (+/- 5), BMI (+/- 2 kg/cm2) and starting gonadotropin dose (+/- 75 UI). The primary endpoint was the number of mature oocytes. The secondary endpoints were other parameters and outcomes of COS. We evaluated the convenience of PPOS by analysing the frequency of monitoring sessions. Univariate analysis was performed via univariate conditional logistic regression. Multivariate analysis was performed via conditional multivariate logistic regression for significant parameters in the univariate analysis (p < 0.2). Results The patient characteristics were comparable, except the median age, which was lower in the antagonist group (35.5 vs. 34.6 years, p < 0.001). Multivariate analysis revealed no statistically significant difference in the number of metaphase II (MII) oocytes between the groups (p = 0.91) or in the total number of COCs retrieved (0.94). There was no statistically significant difference between the groups in terms of the maturation rate or the OSI (p = 0.38 and p = 0.16). The number of monitoring sessions was significantly lower in the PPOS protocol group (p < 0.001). Conclusion The response to ovarian stimulation with the PPOS protocol for oocyte cryopreservation in patients with nonmedical indications does not differ statistically from that with the antagonist protocol in terms of the number of MII oocytes. This protocol offers the advantages of a more patient-friendly approach through oral administration, a significantly lower number of monitoring sessions with the same efficacy as the antagonist protocol and could be offered as a first line treatment. Clinical trial number NA. Trial registration date NA. |
| format | Article |
| id | doaj-art-9d9f0146c87741cc8fd4b2b4cf7f4dfb |
| institution | OA Journals |
| issn | 1477-7827 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Biology and Endocrinology |
| spelling | doaj-art-9d9f0146c87741cc8fd4b2b4cf7f4dfb2025-08-20T01:49:38ZengBMCReproductive Biology and Endocrinology1477-78272025-05-0123111010.1186/s12958-025-01402-2Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control studyOphélie Sounigo0Léah Cohen Aloro1Michael Grynberg2Céleste Becquart3Maxence Majer4Vincent Puy5Christophe Sifer6Claire Vinolas7Florence Eustache8Laetita Hesters9Anne Mayeur10Isabelle Cedrin-Durnerin11Charlotte Sonigo12Maeliss Peigné13Department of Reproductive Medicine and Fertility Preservation, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Paris-Saclay, Assistance Publique Hopitaux de Paris, Antoine Beclere HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Biology of Reproduction, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Biology of Reproduction, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalCECOS, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Biology of Reproduction, Universite Paris-Saclay, Assistance Publique Hopitaux de Paris, Antoine Beclere HospitalDepartment of Biology of Reproduction, Universite Paris-Saclay, Assistance Publique Hopitaux de Paris, Antoine Beclere HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Paris-Saclay, Assistance Publique Hopitaux de Paris, Antoine Beclere HospitalDepartment of Reproductive Medicine and Fertility Preservation, Universite Sorbonne Paris Nord, Assistance Publique– Hopitaux de Paris, Jean Verdier HospitalAbstract Background The PPOS (Progestin Primed Ovarian Stimulation) protocol has been evaluated and has proved its effectiveness in preventing the LH (luteinizing hormone) surge. This protocol is often used for cryopreservation for social reasons because it is simpler and more cost-effective. The objective of our study was to evaluate the efficacy and the convenience of the PPOS protocol in the context of oocyte cryopreservation for social reasons. Methods In this bicentric matched case‒control study, all PPOS cycles performed for nonmedical reasons between January 2021 and June 2023 were included. Each PPOS cycle was matched with 2 control cycles performed with the antagonist protocol on the basis of the antral follicle count (+/- 5), BMI (+/- 2 kg/cm2) and starting gonadotropin dose (+/- 75 UI). The primary endpoint was the number of mature oocytes. The secondary endpoints were other parameters and outcomes of COS. We evaluated the convenience of PPOS by analysing the frequency of monitoring sessions. Univariate analysis was performed via univariate conditional logistic regression. Multivariate analysis was performed via conditional multivariate logistic regression for significant parameters in the univariate analysis (p < 0.2). Results The patient characteristics were comparable, except the median age, which was lower in the antagonist group (35.5 vs. 34.6 years, p < 0.001). Multivariate analysis revealed no statistically significant difference in the number of metaphase II (MII) oocytes between the groups (p = 0.91) or in the total number of COCs retrieved (0.94). There was no statistically significant difference between the groups in terms of the maturation rate or the OSI (p = 0.38 and p = 0.16). The number of monitoring sessions was significantly lower in the PPOS protocol group (p < 0.001). Conclusion The response to ovarian stimulation with the PPOS protocol for oocyte cryopreservation in patients with nonmedical indications does not differ statistically from that with the antagonist protocol in terms of the number of MII oocytes. This protocol offers the advantages of a more patient-friendly approach through oral administration, a significantly lower number of monitoring sessions with the same efficacy as the antagonist protocol and could be offered as a first line treatment. Clinical trial number NA. Trial registration date NA.https://doi.org/10.1186/s12958-025-01402-2Social freezingFertility preservationDydrogesteroneProgestin-stimulated ovarian stimulationOvarian stimulation index |
| spellingShingle | Ophélie Sounigo Léah Cohen Aloro Michael Grynberg Céleste Becquart Maxence Majer Vincent Puy Christophe Sifer Claire Vinolas Florence Eustache Laetita Hesters Anne Mayeur Isabelle Cedrin-Durnerin Charlotte Sonigo Maeliss Peigné Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control study Reproductive Biology and Endocrinology Social freezing Fertility preservation Dydrogesterone Progestin-stimulated ovarian stimulation Ovarian stimulation index |
| title | Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control study |
| title_full | Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control study |
| title_fullStr | Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control study |
| title_full_unstemmed | Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control study |
| title_short | Progestin-primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications: a case–control study |
| title_sort | progestin primed ovarian stimulation for oocyte cryopreservation in patients with nonmedical indications a case control study |
| topic | Social freezing Fertility preservation Dydrogesterone Progestin-stimulated ovarian stimulation Ovarian stimulation index |
| url | https://doi.org/10.1186/s12958-025-01402-2 |
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