〔Abstract〕 Objective To explore the clinical efficacy of microstimulation and progestin primed ovarian stimulation (PPOS) during in vitro fertilization (IVF) -embryo transfer (ET) cycle in patients with diminished ova-rian reserve (DOR). Methods A total of 72 patients with DOR who underwent IVF-ET treatment in the reproductive center of Xuzhou Maternal and Child Health Hospital from January 2019 to December 2020 were selected as the study objects. Their clinical data were retrospectively analyzed, and they were divided into an observation group and a control group according to different ovulation promotion schemes, with 36 cases in each group. The patients in the observation group received PPOS scheme and the control group received microstimulation scheme. Ovulation induction, serum sex hormone level on human chorionic gonadotropin (HCG) injection day and clinical pregnancy outcome were observed in the two groups. Results The consumption of gonadotropin (Gn), the number of eggs harvested and the number of available embryos in the observation group were higher than those in the control group, and the use time of Gn was longer than that in the control group, with statistical significance (P < 0.05). The levels of serum estradiol (E2), progesterone (P) and luteinizing hormone (LH) on HCG injection day in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The clinical pregnancy rate of the observation group was higher than that of the control group, and the cycle cancellation rate was lower than that of the control group, the differences were statistically significant (P < 0.05). There was no significant difference in the early abortion rate between the two groups (P > 0.05). Conclusion PPOS scheme is a feasible and effective ovulation induction scheme. The application of PPOS scheme in the IVF-ET cycle of patients with DOR can strive for more pregnancy opportunities and obtain satisfactory clinical pregnancy outcome, which provides a new choice for ovulation induction in patients with DOR.