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Progestin as an Inhibitor of Premature Ovulation through LH Suppression in IVF .
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Progestin is a synthetic form of progesterone hormone. Progestin is used as a contraceptive pill. Progestin can suppress endogenous Luteinizing Hormone (LH) secretion from the pituitary. Premature ovulation in Assisted Reproductive Technology (ART)can be prevented by taking progestin. Progestin–Primed Ovarian Stimulation (PPOS) is now widely used for the treatment of infertility through IVF. Progestin pills are more effective than GnRH analogue for patients. Progestins are an excellent alternative to antagonists. PPOS is slightly more advantageous than the Controlled Ovarian Stimulation (COS) protocol. Progesterone regulates follicular growth through PI3K/AKT and MAPK signaling pathway
Keywords
GnRH Analogue, IVF, Progestin, PPOS .
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- Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clinical biochemistry. 2018; 62:2-10. https://doi. org/10.1016/j.clinbiochem.2018.03.012 PMid:29555319
- Diamond MP, Kruger M, Santoro N, Zhang H, Casson P, Schlaff W, Coutifaris C, Brzyski R, Christman G, Carr BR, McGovern PG. Endometrial shedding effect on conception and live birth in women with polycystic ovary syndrome. Obstetrics and Gynecology. 2012; 119(5):902-8. https://doi.org/10.1097/AOG.0b013e31824da35c PMid:22525900 PMCid:PMC4007263
- La Marca A, Capuzzo M. Use of progestins to inhibit spontaneous ovulation during ovarian stimulation: the beginning of a new era? Reproductive Biomedicine Online. 2019; 39(2):321-31. https://doi.org/10.1016/j.rbmo.2019.03.212 PMid:31138494
- Messinis IE, Messini CI, Dafopoulos K. Novel aspects of the endocrinology of the menstrual cycle. Reproductive biomedicine online. 2014; 28(6):714-22. https://doi.org/10.1016/j.rbmo.2014.02.003 PMid:24745832
- Mehta RH, Anand Kumar TC. Can GnRH agonists act directly on the ovary and contribute to cyst formation? Human Reproduction. 2000; 15(3):505-7. https://doi.org/10.1093/humrep/15.3.505 PMid:10686187
- 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(21). https://doi.org/10.1097/ MD.0000000000000909 PMid:26020402 PMCid:PMC4616424
- Serour GI, Aboulghar M, Mansour R, Sattar MA, Amin Y, Aboulghar H. Complications of medically assisted conception in 3,500 cycles. Fertility and Sterility. 1998; 70(4):638-42. https://doi.org/10.1016/S0015-0282(98)00250-7
- Talaulikar VS, Arulkumaran S. Maternal, perinatal and long-term outcomes after assisted reproductive techniques (ART): implications for clinical practice. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2013; 170(1):13-9. https://doi.org/10.1016/j.ejogrb.2013.04.014 PMid:23759305
- Wei D, Shi Y, Li J, Wang Z, Zhang L, Sun Y, Zhou H, Xu Y, Wu C, Liu L, Wu Q. Effect of pretreatment with oral contraceptives and progestins on IVF outcomes in women with polycystic ovary syndrome. Human Reproduction. 2017; 32(2):354-61. https://doi. org/10.1093/humrep/dew325 PMid:27999118 PMCid:PMC5870982
- Wang Y, Chen Q, Wang N, Chen H, Lyu Q, Kuang Y. 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(9). https://doi.org/10.1097/MD.0000000000002939 PMid:26945402 PMCid:PMC4782886
- 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. Current Medical Science. 2019; 39(3):431-6. https://doi.org/10.1007/s11596-019-2055-x PMid:31209815
- Garcia-Velasco JA, Fatemi HM. To pill or not to pill in GnRH antagonist cycles: that is the question! Reproductive BioMedicine Online. 2015; 30(1):39-42. https://doi.org/10.1016/j.rbmo.2014.09.010 PMid:25447926
- Ganesh A, Chakravorty N, Mukherjee R, Goswami S, Chaudhury K, Chakravarty B. Comparison of oral dydrogestrone with progesterone gel and micronized progesterone for luteal support in 1,373 women undergoing in vitro fertilization: A randomized clinical study. Fertility and Sterility. 2011; 95(6):1961-5. https://doi.org/10.1016/j.fertnstert.2011.01.148 PMid:21333984
- Germond M, Capelli P, Bruno G, Vesnaver S, Senn A, Rouge N, Biollaz J. Comparison of the efficacy and safety of two formulations of micronized progesterone (Ellios™ and Utrogestan™) used as luteal phase support after in vitro fertilization. Fertility and Sterility. 2002; 77(2):313-7. https://doi.org/10.1016/S0015-0282(01)02979-X
- Ata B, Capuzzo M, Turkgeldi E, Yildiz S, La Marca A. Progestins for pituitary suppression during ovarian stimulation for ART: A comprehensive and systematic review including meta-analyses. Human Reproduction Update. 2021; 27(1):48-66. https://doi. org/10.1093/humupd/dmaa040 PMid:33016316
- Schindler AE, Campagnoli C, Druckmann R, Huber J, Pasqualini JR, Schweppe KW, Thijssen JH. Classification and pharmacology of progestins. Maturitas. 46: S7-S16. https://doi.org/10.1016/j.maturitas.2003.09.014 PMid:14670641
- Kuang Y, Chen Q, Fu Y, Wang Y, Hong Q, Lyu Q, Ai A, Shoham Z. Medroxyprogesterone acetate is an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization. Fertility and Sterility. 2015; 104(1):62-70. https://doi.org/10.1016/j.fertnstert.2015.03.022 PMid:25956370
- Evans NP, Richter TA, Skinner DC, Robinson JE. Neuroendocrine mechanisms underlying the effects of progesterone on the oestradiol-induced GnRH/LH surge. Reproduction (Cambridge, England) Supplement. 2002; 59:57-66.
- Heikinheimo O, Gordon K, Williams RF, Hodgen GD. Inhibition of ovulation by progestin analogs (agonists vs antagonists): preliminary evidence for different sites and mechanisms of actions. Contraception. 1996; 53(1):55-64. https://doi.org/10.1016/00107824(95)00255-3
- Gordon A, Garrido-Gracia JC, Aguilar R, Sánchez-Criado JE. Understanding the regulation of pituitary progesterone receptor expression and phosphorylation. Reproduction. 2015; 149(6):615-23. https://doi.org/10.1530/REP-14-0592 PMid:25926689
- Chen Q, Chai W, Wang Y, Cai R, Zhang S, Lu X, Zeng X, Sun L, Kuang Y. 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. Frontiers in Endocrinology. 2019; 10:796. https://doi.org/10.3389/fendo.2019.00796 PMid:31824419 PMCid:PMC6882854
- Inaudi P, Barra V, Vellucci FL, Regini C, Luisi S. GnRH antagonist does not prevent premature luteinization and ovulation in stimulated cycles with gonadotropins for IVF: Two case reports. Gynecological Endocrinology. 2018; 34(3):189-91. https://doi. org/10.1080/09513590.2017.1380183 PMid:28942696
- Attardi B, Scott R, Pfaff D, Fink G. Facilitation or Inhibition of the Oestradiol‐Induced Gonadotrophin Surge in the Immature Female Rat by Progesterone: Effects on Pituitary Responsiveness to Gonadotrophin‐Releasing Hormone (GnRH), GnRH Self‐Priming and Pituitary mRNAs for the Progesterone Receptor A and B Isoforms. Journal of Neuroendocrinology. 2007; 19(12):988-1000. https://doi.org/10.1111/j.1365-2826.2007.01613.x PMid:18001329
- Polexa A, Yildiz S, Ata B. The effectiveness of progestins for pituitary suppression during ovarian stimulation in IVF procedures. Acta Medica Transilvanica. 2021; 26(1). https://doi.org/10.2478/amtsb-2020-0016
- Chen H, qin Chen Z, Ng EH, Yao D. Comparison of the Cumulative Live Birth Rates After One ART Cycle Including All Subsequent Frozen-thaw Cycles in Women Undergoing IVF Using Progestin Primed Ovarian Stimulation Versus Long GnRH Agonist Protocol. Research Square 2021. https://doi.org/10.22541/au.162654880.07207801/v1
- Zolfaroli I, Ferriol GA, Mora JJ, Cano A. Impact of progestin ovarian stimulation on newborn outcomes: a meta-analysis. Journal of assisted reproduction and genetics. 2020; 37(5):1203-12. https://doi.org/10.1007/s10815-020-01755-0 PMid:32215824 PMCid:PMC7244671
- Durdağ GD, Bektaş G, Türkyılmaz E, et al. The efficacy of dydrogesteroneuse to suppress premature luteinizing hormone surge on cycle outcomes in controlled ovarian stimulation. Journal of the Turkish German Gynecological Association. 2021; 22(4):293. https://doi.org/10.4274/jtgga.galenos.2020.2020.0110 PMid:33389927 PMCid:PMC8666995
- Huang J, Xie Q, Lin J, Lu X, Zhu J, Gao H, Cai R, Kuang Y. Progestin-primed ovarian stimulation with dydrogesterone versus medroxyprogesterone acetate in women with Polycystic Ovarian Syndrome for in vitro fertilization: a retrospective cohort study. Drug Design, Development and Therapy. 2019; 13:4461. https://doi.org/10.2147/DDDT.S230129 PMid:32099323 PMCid:PMC6997218
- Beguería R, García D, Vassena R, Rodríguez A. Medroxyprogesterone acetate versus ganirelix in oocyte donation: a randomized controlled trial. Human Reproduction. 2019; 34(5):872-80. https://doi.org/10.1093/humrep/dez034 PMid:30927417
- Long H, Yu W, Yu S, et al. Progesterone affects clinic oocyte yields by coordinating with follicle stimulating hormone via PI3K/AKT and MAPK pathways. Journal of Advanced Research. 2021; 33:189-99. https://doi.org/10.1016/j.jare.2021.02.008 PMid:34603789 PMCid:PMC8463924
- Hunzicker-Dunn M, Maizels ET. FSH signaling pathways in immature granulosa cells that regulate target gene expression: branching out from protein kinase A. Cellular Signalling. 2006; 18(9):1351-9. https://doi.org/10.1016/j.cellsig.2006.02.011 PMid:16616457 PMCid:PMC1564187
- Robker RL, Richards JS. Hormone-induced proliferation and differentiation of granulosa cells: a coordinated balance of the cell cycle regulators cyclin D2 and p27Kip1. Molecular Endocrinology. 1998; 12(7):924-40. https://doi.org/10.1210/mend.12.7.0138 PMid:9658398
- Burgering BM, Kops GJ. Cell cycle and death control: long live Forkheads. Trends in biochemical sciences. 2002; 27(7):352-60. https://doi.org/10.1016/S0968-0004(02)02113-8
- Burgering BM, Medema RH. Decisions on life and death: FOXO Forkhead transcription factors are in command when PKB/Akt is off duty. Journal of leukocyte biology. 2003; 73(6):689-701. https://doi.org/10.1189/jlb.1202629 PMid:12773501
- Huang H, Itaya Y, Samejima K, et al. Usefulness of random-start progestin-primed ovarian stimulation for fertility preservation. Journal of Ovarian Research. 2022; 15(1):1-6. https://doi.org/10.1186/s13048-021-00935-5n PMid:34983605 PMCid:PMC8725433
- Kasum M, von Wolff M, Franulic D, et al. Fertility preservation options in breast cancer patients. Gynecological Endocrinology. 2015; 31(11):846-51.
- Yu S, Long H, Chang HY, et al. New application of dydrogesterone as a part of a progestin-primed ovarian stimulation protocol for IVFA randomized controlled trial including 516 first IVF/ICSI cycles. Human Reproduction. 2018; 33(2):229-37. https://doi. org/10.1093/humrep/dex367 PMid:29300975 .
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