A Comparison between progesterone-primed ovarian stimulation and GnRH antagonist protocol in the ART population undergoing freeze-all cycle bi-centric study.

Objective The objective of this study was to evaluate the efficacy of the Progestin-Primed Ovarian Stimulation (PPOS) protocol in comparison to the GnRH antagonist protocol within our IVF / ICSI patient cohort. Materials and methods The present retrospective study was conducted from June 2023 to March 2025 in two centres in India among females undergo ART treatment. Out of 843 patients were included(n = 551) patients were kept in progesterone-primed ovarian stimulation (PPOS protocol) Group 1 while(n = 292) patient were assigned to GnRH antagonist protocol Group II respectively. Patients were further subdivided into 3 sub-groups based on there AMH values. Progesterone-primed ovarian stimulation (PPOS) is a promising treatment option for females with hyper response, like polycystic ovarian syndrome (PCOS). Results: Comparative analysis of outcomes between two Group I (PPOS regimen) and Group II (Antagonist regimen), respectively Group 1 Group II were compared as per the primary and secondary outcome parameters. Pregnancy in Group I & II- no significant difference between groups in terms of distribution of pregnancy [p = 0.0947; χ ²  = 0.004] No statistically significant difference in pregnancy outcomes was observed between the two groups across all AMH subgroups (< 2 ng/mL, 2–5 ng/mL, and > 5 ng/mL), with p-values of 0.675, 0.118, and 0.442, respectively. Conclusion The PPOS and GnRH antagonist protocols exhibited similar pregnancy outcomes with hyper-responder patients, clinicians should prefer the PPOS protocol for convenience, and reduction in the incidence of LH surge and OHSS.