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From freeze all protocoles: endogenous and exogenous progesterone use during ovarian stimulation Volume 18, issue 3, Juillet-Août-Septembre 2016

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Author
Service de gynécologie-obstétrique et reproduction, centre hospitalier intercommunal, université Paris 12, 40 avenue de Verdun, 94000 Créteil
* Tirés à part

Improvement of cryopreservation's techniques with oocyte and embryo vitrification allows reproductive physicians to rethink their controlled ovarian hyperstimulation protocols before in vitro fertilization. As frozen embryo transfer gives the same rate of succes, or even better results, as fresh transfer, the physician is no more linked to the following sequence: controlled ovarian hyperstimulation – pick up – transfer. This leads to the “freeze all” strategy and no more worries about the deleterious impact on endometrium of hormonal environment during follicular stimulation. In this paper, we review all the new protocols using progesterone to prevent the LH surge during controlled ovarian hyperstimulation. There are 2 different sources of progesterone: endogenous with the luteal stimulation protocols and exogenous with the progestin primed ovarian stimulation (PPOS). Different protocols are derived of these and the application in clinical practice is discuss in this review.