BACKGROUND Previous studies have demonstrated that progestin-primed ovarian stimulation (PPOS) protocol was a feasible and efficient method in in vitro fertilization (IVF) cycle. However, its application in women with advanced age has not been determined yet. The purpose of this study was to investigate its efficacy in women aged ≥40 years old. METHODS This retrospective cohort study included patients with ages of ≥40 years old at the time of ovarian stimulation. The embryonic and clinical outcome of mild stimulation and PPOS were compared. Primary outcome was top-quality embryo rate on day 3, and secondary outcome was clinical pregnancy rate. RESULTS Baseline characteristics of patients was similar in mild stimulation (122 cycles) and PPOS (47 cycles). No significant difference was found in the number of retrieved and mature oocytes and the fertilization and cleavage rates. Of interest, the rate of top-quality embryos was significantly higher in PPOS group (50.08% vs 33.29%, p = 0.015), with an increasing trend of viable embryo rate (73.55% vs 61.16%). A greater amount of gonadotropin was observed in PPOS group (2061.17 ± 1254.63 IU vs 1518.14 ± 547.25 IU, p < 0.05) in spite of comparable duration of stimulation. After FET cycle, no significant difference was found in the clinical pregnancy rates between mild stimulation (12.5%) and PPOS group (16.7%). CONCLUSIONS Higher percentage of top-quality embryos on Day 3 and comparable clinical pregnancy rate was obtained in PPOS protocol, which could be considered as a feasible ovarian stimulation protocol in women aged above 40 years old.

中文翻译：

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一项回顾性队列研究显示，孕激素引发的卵巢刺激与40岁以上老年妇女的轻度刺激。

背景技术先前的研究表明，孕激素引发的卵巢刺激（PPOS）方案是体外受精（IVF）周期的一种可行且有效的方法。但是，尚未确定其在高龄妇女中的应用。这项研究的目的是调查其对≥40岁女性的疗效。方法这项回顾性队列研究包括卵巢刺激时年龄≥40岁的患者。比较了轻度刺激和PPOS的胚胎和临床结局。主要结局是第3天的优质胚胎发生率，次要结局是临床妊娠率。结果在轻度刺激（122个周期）和PPOS（47个周期）中，患者的基线特征相似。回收的卵母细胞和成熟的卵母细胞的数量以及受精和卵裂率没有显着差异。有趣的是，PPOS组中优质胚胎的发生率显着更高（50.08％对33.29％，p = 0.015），而活胚率则呈上升趋势（73.55％对61.16％）。尽管刺激时间相当，PPOS组仍观察到促性腺激素的量更大（2061.17±1254.63 IU vs 1518.14±547.25 IU，p <0.05）。FET周期后，轻度刺激（12.5％）和PPOS组（16.7％）之间的临床妊娠率没有显着差异。结论在PPOS方案中，在第3天获得了较高质量的胚胎百分比，并且具有相当的临床妊娠率，这可以被认为是40岁以上女性可行的卵巢刺激方案。