and Reggio Emilia, Italy. His clinical activity covers all fields of reproductive medicine and surgery. He has published extensively; his current h-index is 44, with more than 8000 citations.

BACKGROUND Progestins are capable of suppressing endogenous LH secretion from the pituitary. Progestins can be used orally and are less expensive than GnRH analogues. However, early endometrial exposure to progestin precludes a fresh embryo transfer (ET), but the advent of vitrification and increasing number of oocyte cryopreservation cycles allow more opportunities for using progestins for pituitary suppression. OBJECTIVE AND RATIONALE This review summarizes: the mechanism of pituitary suppression by progestins; the effectiveness of progestins when compared with GnRH analogues and with each other; the effect of progestins on oocyte and embryo developmental potential and euploidy status; and the cost-effectiveness aspects of progestin primed stimulation. Future research priorities are also identified. SEARCH METHODS The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, the Web of Science and Scopus were screened with a combination of keywords related to ART, progesterone, GnRH analogue and ovarian stimulation, in various combinations. The search period was from the date of inception of each database until 1 April 2020. Only full text papers published in English were included. OUTCOMES Overall, the duration of stimulation, gonadotrophin consumption and oocyte yield were similar with progestins and GnRH analogues. However, sensitivity analyses suggested that progestins were associated with significantly lower gonadotrophin consumption than the long GnRH agonist protocol (mean difference (MD) = −648, 95% CI = −746 to −550 IU) and significantly higher gonadotrophin consumption than the short GnRH agonist protocol (MD = 433, 95% CI = 311 to 555 IU). Overall, live birth, ongoing and clinical pregnancy rates per ET were similar with progestins and GnRH analogues. However, when progestins were compared with GnRH agonists, sensitivity analyses including women with polycystic ovary syndrome (risk ratio (RR) = 1.27, 95% CI = 1.06 to 1.53) and short GnRH agonist protocols (RR = 1.14, 95% CI = 1.02 to 1.28) showed significantly higher clinical pregnancy rates with progestins. However, the quality of evidence is low. Studies comparing medroxyprogesterone acetate, dydrogesterone and micronized progesterone suggested similar ovarian response and pregnancy outcomes. The euploidy status of embryos from progestin primed cycles was similar to that of embryos from conventional stimulation cycles. Available information is reassuring regarding obstetric and neonatal outcomes with the use of progestins. Despite the lower cost of progestins than GnRH analogues, the mandatory cryopreservation of all embryos followed by a deferred transfer may increase cost per live birth with progestins as compared to an ART cycle culminating in a fresh ET. WIDER IMPLICATIONS Progestins can present an effective option for women who do not contemplate a fresh ET, e.g. fertility preservation, anticipated hyper responders, preimplantation genetic testing, oocyte donors, double stimulation cycles.

His activity covers the whole field of reproductive medicine and surgery. He is the author of 160 articles in peer-reviewed journals and a recipient of competitively assigned research funds.

Pregnant women with coronavirus disease 2019 show overall similar clinical features as that of nonpregnant adults with COVID-19, except perhaps for higher risk of admission to the intensive care unit (ICU) and mechanical ventilation. 1 Among pregnant women with COVID-19, more than 85% to 90% have no or mild symptoms, 5% to 10% have symptoms severe enough to warrant hospitalization and at times oxygen therapy but no mechanical ventilation, and 1% to 2% develop critical disease requiring mechanical ventilation and at times leading even to death. 1 Most promising therapeutic possibilities for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy include currently remdesivir and convalescent plasma (CP). In this study, we present a case of a pregnant woman treated with CP at the city hospital of Mantova in Italy. STUDY DESIGN:This study involved a 29-year-old gravida 2, para 1 patient (previous preterm birth at 36 4/7 weeks of gestation) with a body mass index of 31 and with a singleton gestation who presented at the emergency room on April 9, 2020 at 24 2/7 weeks of gestation with worsening cough and fever, which started approximately 7 days before.At presentation, she was febrile (38.0 C) and normotensive, with a respiratory rate of 20 bpm and an O 2 saturation (SpO 2 ) of 95%. Laboratory tests showed normal white blood cell and procalcitonin values, a C-reactive protein concentration of 58.6 mg/L, and normal arterial blood gas values. The polymerase chain reaction (PCR) nasopharyngeal (NP) FIGURE Case report: graphical course of laboratory and clinical parameters Grisolia. Convalescent plasma for coronavirus disease 2019 in pregnancy. AJOG MFM 2020.

STUDY QUESTION Does the prevalence of euploid blastocysts differ between patients treated with progestin primed ovarian stimulation (PPOS) and those treated with conventional ovarian stimulation? SUMMARY ANSWER The numbers of blastocysts and euploid blastocysts per patient and the number of euploid embryos per injected oocyte are similar for patients undergoing progestin-primed ovarian stimulation and for those undergoing conventional ovarian stimulation with GnRH antagonist. WHAT IS KNOWN ALREADY New approaches to ovarian stimulation have been developed based on the use of drugs administrable by mouth instead of via injections. Attention has been dedicated to progestins to block the LH surge. Previous data regarding the number of oocytes retrieved and the number of good-quality embryos generated in PPOS have demonstrated similar outcomes when compared to conventional ovarian stimulation, even if some concerns regarding the quality of embryos have been advanced. STUDY DESIGN, SIZE, DURATION This is a prospective non-inferiority age-matched case–control study. In a period of 6 months, a total of 785 blastocysts from 1867 injected oocytes obtained from 192 patients were available for analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS Infertile women undergoing IVF and preimplanation genetic testing (PGT) cycles were included. Forty-eight patients were treated with PPOS, and for each of them three age-matched historical controls (n = 144) treated with a GnRH antagonist protocol were selected. PGT was performed according to next-generation sequencing technology. MAIN RESULTS AND THE ROLE OF CHANCE Basal characteristics were similar in the two groups; a substantial similarity of the main outcome measures in the two treatment groups has also been found. The rate of formation of euploid blastocysts per oocyte was 21% in both the two treatment groups. The percentage of patients with euploid embryos and the total number of euploid blastocysts per patient (median and interquartile range, IQR) in the PPOS group were 38.7 (25.5–52.9) and 2 (1.3–3.1), respectively. These figures were not significantly different in women treated with the GnRH antagonist protocol i.e. 42 (28–53.8) and 2.1 (1.3–2.9), respectively. LIMITATIONS, REASONS FOR CAUTION This was a case–control study which may limit the reliability of the main findings. WIDER IMPLICATIONS OF THE FINDINGS Our results encourage the use of PPOS, especially for oocyte donation, for fertility preservation and for patients in which total freezing of embryos is foreseen, for those expected to be high responders or candidates for preimplantation genetic testing. However, studies aiming to investigate the effect of PPOS on the live birth rate are warranted. STUDY FUNDING/COMPETING INTEREST(S) None.