Exposure of antral follicles to medroxyprogesterone acetate during stimulation does not cause molecular perturbations in gonadotropin-responsiveness and steroidogenic function of granulosa cells in progestin-primed cycles.

This article investigates whether exposure to medroxyprogesterone acetate (MPA) in progestin-primed ovarian stimulation (PPOS) cycles causes molecular changes in the steroidogenic function and gonadotropin responsiveness of granulosa cells compared to traditional gonadotropin-releasing hormone (GnRH) antagonist cycles in normal responding IVF patients. The study found no significant differences between PPOS and GnRH antagonist protocols in clinical IVF outcomes, expression of steroidogenic enzymes, gonadotropin and sex steroid receptors, or the granulosa cells’ response to FSH and hCG stimulation at the molecular level. These findings suggest that MPA exposure during follicular growth in PPOS cycles does not adversely affect steroidogenesis, ovulation-related gene expression, or luteal function, supporting PPOS as a safe alternative to GnRH antagonist protocols in IVF. Limitations include the study’s focus on normal responders, use of only MPA as the progestin, and lack of data on other infertility etiologies or ovarian pathologies.