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Chapter 10 - Progestin-Primed Ovarian Stimulation

from Section 2 - Ovarian Hyperstimulation for IVF

Published online by Cambridge University Press:  14 April 2022

By
Xuefeng Lu  and
Yanping Kuang
Edited by
Mohamed Aboulghar  and
Botros Rizk
Mohamed Aboulghar
Affiliation:
University of Cairo IVF Centre
Botros Rizk
Affiliation:
University of South Alabama
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Summary

The reproductive cycle requires complex interactions and feedback between gonadotropin-releasing hormone (GnRH), the gonadotropins follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and the ovarian sex steroid hormones estrogen and progesterone. To improve the success rate of in vitro fertilization-embryo transfer (IVF-ET) by optimizing oocyte retrieval, controlled ovarian stimulation (COS) has been widely performed. Exogenous gonadotropins were used to achieve supraphysiological levels during the follicular phase to override the process of dominant follicle selection and enable multiple follicular recruitment, which lead to a rapidly increasing serum estradiol level and induce a premature LH surge. GnRH agonist (GnRHa) and GnRH antagonist were used to prevent the premature LH surge and premature ovulation [1]. In 2003, based on ultrasonographic studies, Baerwald et al. demonstrated that multiple cohorts or “waves” of 2–5 mm follicles were recruited continuously during a menstrual cycle, including in the luteal phase [2;3].

Type
Chapter
Information
Ovarian Stimulation , pp. 93 - 100
Publisher: Cambridge University Press
Print publication year: 2022

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References

Macklon, NS, Stouffer, RL, Giudice, LC, Fauser, BC. The science behind 25 years of ovarian stimulation for in vitro fertilization. Endocr Rev 2006;27:170–207.Google Scholar
Baerwald, AR, Adams, GP, Pierson, RA. Characterization of ovarian follicular wave dynamics in women. Biol Reprod 2003;69:1023–1031.Google Scholar
Baerwald, AR, Adams, GP, Pierson, RA. A new model for ovarian follicular development during the human menstrual cycle. Fertil Steril 2003;80:116–122.Google Scholar
McNatty, KP, Hillier, SG, van den Boogaard, AM, et al. Follicular development during the luteal phase of the human menstrual cycle. J Clin Endocrinol Metab 1983;56:1022–1031.CrossRefGoogle ScholarPubMed
von Wolff, M, Thaler, CJ, Frambach, T, et al. Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil Steril 2009;92:1360–1365.Google Scholar
Bedoschi, GM, de Albuquerque, FO, Ferriani, RA, Navarro, PA. Ovarian stimulation during the luteal phase for fertility preservation of cancer patients: case reports and review of the literature. J Assist Reprod Genet 2010;27:491–494.CrossRefGoogle ScholarPubMed
Sonmezer, M, Turkcuoglu, I, Coskun, U, Oktay, K. Random-start controlled ovarian hyperstimulation for emergency fertility preservation in letrozole cycles. Fertil Steril 2011;95(2125):e9–e11.CrossRefGoogle ScholarPubMed
Kuang, YP, Chen, QJ, Hong, QQ, et al. Luteal-phase ovarian stimulation case report: three-year follow-up of a twin birth. J IVF Reprod Med Genet 2013;1(2):1000106.Google Scholar
Buendgen, NK, Schultze-Mosgau, A, Cordes, T, Diedrich, K, Griesinger, G. Initiation of ovarian stimulation independent of the menstrual cycle: a case-control study. Arch Gynecol Obstet 2013;288:901–904.CrossRefGoogle ScholarPubMed
Kuang, Y, Hong, Q, Chen, Q, et al. Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles. Fertil Steril 2014;101:105–111.Google Scholar
Wang, N, Wang, Y, Chen, Q, et al. Luteal-phase ovarian stimulation vs conventional ovarian stimulation in patients with normal ovarian reserve treated for IVF: a large retrospective cohort study. Clin Endocrinol 2016;84:720–728.Google Scholar
Li, Y, Yang, W, Chen, X, et al. Comparison between follicular stimulation and luteal stimulation protocols with clomiphene and HMG in women with poor ovarian response. Gynecol Endocrinol 2016;32:74–77.Google Scholar
Spies, HG, Niswender, GD. Blockade of the surge of preovulatory serum luteinizing hormone and ovulation with exogenous progesterone in cycling rhesus (Macaca mulatta) monkeys. J Clin Endocrinol Metab 1971;32:309–316.Google Scholar
Dierschke, DJ, Yamaji, T, Karsch, FJ, et al. Blockade by progesterone of estrogen-induced LH and FSH release in the rhesus monkey. Endocrinology 1973;92:1496–1501.Google Scholar
Pohl, CR, Knobil, E. The role of the central nervous system in the control of ovarian function in higher primates. Annu Rev Physiol 1982;44:583–593.CrossRefGoogle ScholarPubMed
March, CM, Goebelsmann, U, Nakamura, RM, Mishell, DR, Jr. Roles of estradiol and progesterone in eliciting the midcycle luteinizing hormone and follicle-stimulating hormone surges. J Clin Endocrinol Metabol 1979;49:507–513.Google Scholar
Wu, Y, Zhao, FC, Sun, Y, Liu, PS. Luteal-phase protocol in poor ovarian response: a comparative study with an antagonist protocol. J Int Med Res 2017;45:1731–1738.Google Scholar
Zhang, W, Wang, M, Wang, S, et al. Luteal phase ovarian stimulation for poor ovarian responders. JBRA Assist Reprod 2018;22:193–198.Google Scholar
Ubaldi, FM, Capalbo, A, Vaiarelli, A, et al. Follicular versus luteal phase ovarian stimulation during the same menstrual cycle (DuoStim) in a reduced ovarian reserve population results in a similar euploid blastocyst formation rate: new insight in ovarian reserve exploitation. Fertil Steril 2016;105:1488.e1–1495.e1.Google Scholar
Chen, H, Wang, Y, Lyu, Q, et al. Comparison of live-birth defects after luteal-phase ovarian stimulation vs. conventional ovarian stimulation for in vitro fertilization and vitrified embryo transfer cycles. Fertil Steril 2015;103:1194.e2–1201.e2.CrossRefGoogle ScholarPubMed
Cimadomo, D, Vaiarelli, A, Colamaria, S, et al. Luteal phase anovulatory follicles result in the production of competent oocytes: intra-patient paired case-control study comparing follicular versus luteal phase stimulations in the same ovarian cycle. Hum Reprod 2018;33:1442–1448.Google Scholar
Kuang, Y, Chen, Q, Fu, Y, et al. Medroxyprogesterone acetate is an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization. Fertil Steril 2015;104:62.e3–70.e3.Google Scholar
Lu, X, Hong, Q, Sun, L, et al. Dual trigger for final oocyte maturation improves the oocyte retrieval rate of suboptimal responders to gonadotropin-releasing hormone agonist. Fertil Steril 2016;106:1356–1362.CrossRefGoogle ScholarPubMed
Dong, J, Wang, Y, Chai, WR, et al. The pregnancy outcome of progestin-primed ovarian stimulation using 4 versus 10 mg of medroxyprogesterone acetate per day in infertile women undergoing in vitro fertilisation: a randomised controlled trial. BJOG 2017;124:1048–1055.Google Scholar
Wang, Y, Chen, Q, Wang, N, et al. Controlled ovarian stimulation using medroxyprogesterone acetate and hMG in patients with polycystic ovary syndrome treated for IVF: a double-blind randomized crossover clinical trial. Medicine 2016;95:e2939.Google Scholar
Xiao, ZN, Peng, JL, Yang, J, Xu, WM. Flexible GnRH antagonist protocol versus progestin-primed ovarian stimulation (PPOS) protocol in patients with polycystic ovary syndrome: comparison of clinical outcomes and ovarian response. Curr Med Sci 2019;39:431–436.Google Scholar
Chen, Q, Chai, W, Wang, Y, et al. Progestin vs. gonadotropin-releasing hormone antagonist for the prevention of premature luteinizing hormone surges in poor responders undergoing in vitro fertilization treatment: a randomized controlled trial. Front Endocrinol (Lausanne) 2019;10:796.Google Scholar
Yu, S, Long, H, Chang, HY, et al. New application of dydrogesterone as a part of a progestin-primed ovarian stimulation protocol for IVF: a randomized controlled trial including 516 first IVF/ICSI cycles. Hum Reprod 2018;33:229–237.Google Scholar
Zhu, X, Zhang, X, Fu, Y. Utrogestan as an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization. Medicine 2015;94:e909.Google Scholar
Crha, I, Ventruba, P, Filipinska, E, et al. [Medroxyprogesterone acetate use to block LH surge in oocyte donor stimulation]. Ceska gynekologie 2018;83:11–16.Google Scholar
diZerega, GS, Hodgen, GD. Cessation of folliculogenesis during the primate luteal phase. J Clin Endocrinol Metab 1980;51:158–160.Google Scholar
Helmond, FA, Simons, PA, Hein, PR. Strength and duration characteristics of the facilitory and inhibitory effects of progesterone on the estrogen-induced gonadotropin surge in the female rhesus monkey. Endocrinology 1981;108:1837–1842.CrossRefGoogle ScholarPubMed
Helmond, FA, Simons, PA, Hein, PR. The effects of progesterone on estrogen-induced luteinizing hormone and follicle-stimulating hormone release in the female rhesus monkey. Endocrinology 1980;107:478–485.Google Scholar
Gougeon, A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev 1996;17:121–155.CrossRefGoogle ScholarPubMed
Richter, TA, Robinson, JE, Lozano, JM, Evans, NP. Progesterone can block the preovulatory gonadotropin-releasing hormone/luteinising hormone surge in the ewe by a direct inhibitory action on oestradiol-responsive cells within the hypothalamus. J Neuroendocrinol 2005;17:161–169.Google Scholar
Yildiz, S, Turkgeldi, E, Angun, B, et al. Comparison of a novel flexible progestin primed ovarian stimulation protocol and the flexible gonadotropin-releasing hormone antagonist protocol for assisted reproductive technology. Fertil Steril 2019;112:677–683.Google Scholar
Zhang, J, Mao, X, Wang, Y, et al. Neonatal outcomes and congenital malformations in children born after human menopausal gonadotropin and medroxyprogesterone acetate treatment cycles. Arch Gynecol Obstet 2017;296:1207–17.CrossRefGoogle ScholarPubMed
Kuang, Y, Chen, Q, Hong, Q, et al. Double stimulations during the follicular and luteal phases of poor responders in IVF/ICSI programmes (Shanghai protocol). Reprod Biomed Online 2014;29:684–91.Google Scholar
Tsampras, N, Gould, D, Fitzgerald, CT. Double ovarian stimulation (DuoStim) protocol for fertility preservation in female oncology patients. Hum Fertil 2017;20:248–253.Google Scholar
Smitz, J, Van Den Abbeel, E, Bollen, N, et al. The effect of gonadotrophin-releasing hormone (GnRH) agonist in the follicular phase on in-vitro fertilization outcome in normo-ovulatory women. Hum Reprod 1992;7:1098–1102.Google Scholar
Niederberger, C, Pellicer, A, Cohen, J, et al. Forty years of IVF. Fertil Steril 2018;110:185.e5–324.e5.Google Scholar

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