medroxyprogesterone acetate + dienogest + micronized progesterone

This combination refers to the set of oral progestogens—medroxyprogesterone acetate, dienogest, and micronized progesterone—utilized in Progestin-Primed Ovarian Stimulation (PPOS) protocols for patients undergoing in vitro fertilization (IVF). PPOS is an alternative to traditional GnRH analog protocols, leveraging the ability of progestins to suppress the pituitary luteinizing hormone (LH) surge during the follicular phase. In the clinical trial NCT06433128, these agents are administered orally from the early stimulation phase until the day of the trigger. This approach is typically paired with a "freeze-all" strategy, as the progestin exposure makes the endometrium asynchronous for fresh embryo transfer. The individual components are all agonists of the progesterone receptor, providing effective pituitary suppression.