Comparison of IVF Outcomes Between PPOS and Antagonist Protocols in Women With PCOS

A Comparative Study of In Vitro Fertilization Outcomes Between PPOS and Antagonist Protocols in Women With Polycystic Ovary Syndrome

This study aims to compare the outcomes of two ovarian stimulation protocols used in in vitro fertilization (IVF): the progestin-primed ovarian stimulation (PPOS) protocol and the GnRH antagonist protocol.

Inclusion Criteria:

• Women aged 18-40 years
• Diagnosed with polycystic ovary syndrome (PCOS) according to the modified Rotterdam criteria (2004) (≥2 of 3: oligo/anovulation, hyperandrogenism, or polycystic ovarian morphology on ultrasound)
• Indicated for in vitro fertilization (IVF) due to PCOS alone or PCOS with other infertility factors (e.g., tubal factor, previous failed IUI)
• Eligible for controlled ovarian stimulation for IVF
• Husband/partner with normal sperm parameters or mild to moderate oligoasthenoteratozoospermia (OAT)
• Willing and able to provide written informed consent and comply with study procedures.

Exclusion Criteria:

• Uterine abnormalities that may impair implantation or pregnancy outcomes, including congenital uterine malformations, large fibroids distorting the uterine cavity, adenomyosis, or severe intrauterine pathology.
• History of major ovarian or uterine surgery affecting ovarian reserve or uterine structure (e.g., ovarian cystectomy, endometriosis surgery, myomectomy, unilateral oophorectomy)
• History of recurrent pregnancy loss (≥3 spontaneous miscarriages)
• Known chromosomal abnormalities in either partner
• Inability to adhere to study protocol or follow-up procedures