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CLINICAL AND SUBCLINICAL CHARACTERISTICS AND EMBRYO OUTCOMES USING THE RANDOM-START PROGESTIN-PRIMED OVARIAN STIMULATION PROTOCOL IN INFERTILE WOMEN WITH NORMAL OVARIAN RESERVE
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Abstract
Objective: To describe the clinical and ovarian reserve characteristics of infertile women participating in the study and their response to the Random-start Progestin-Primed Ovarian Stimulation (PPOS) protocol in in vitro fertilization (IVF) treatment. Subjects and Methods: This was a retrospective descriptive study conducted at the Military Institute of Clinical Embryology and Histology - Vietnam Military Medical University and Viet Bi Fertility and Andrology Hospital from January 2024 to June 2025. Inclusion criteria included infertile couples undergoing IVF treatment, a freeze-all strategy, and normal ovarian reserve. Serum AMH, antral follicle count (AFC), and hormone levels on the day of stimulation initiation (FSH, LH, estradiol, progesterone, βhCG) were measured. The Random-start PPOS protocol involved using exogenous gonadotropin and progestin at any point in the menstrual cycle, followed by GnRH agonist for oocyte maturation. Intracytoplasmic sperm injection (ICSI) was performed, and embryos were cultured to the blastocyst stage for quality assessment. Results: The mean age of the study group was 33.46 ± 5.76 years, with a mean serum AMH of 3.89 ± 2.35 ng/mL and a mean AFC of 12.50 ± 4.33 follicles. The protocol yielded a mean of 7.60 ± 5.73 mature oocytes (MII), 5.68 ± 4.59 cleavage-stage embryos, and 3.64 ± 3.06 blastocysts. Conclusion: The Random-start PPOS protocol was found to be effective and safe for infertile women with normal ovarian reserve. This protocol not only yielded comparable oocyte and embryo outcomes to current common protocols.
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Keywords
ovarian stimulation, random start, PPOS.
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