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While this observational data has limitations and does not establish causation, the mechanistic basis for the difference is plausible: synthetic progestins like medroxyprogesterone acetate bind progesterone receptors with different affinity and also carry partial androgenic and glucocorticoid activity, whereas micronized progesterone behaves more selectively [5]

CrossRef The Immune Inductive Role of Hepatic Arterial Infusion Chemotherapy Prior to Atezolizumab Plus Bevacizumab Combination Therapy in Hepatocellular Carcinoma Hiroyuki Suzuki, Miwa Sakai, Hideki Iwamoto, Shigeo Shimose, Takashi Niizeki, Masahito Nakano, Tomotake Shirono, Yu Noda, Etsuko Moriyama, Ryoko Kuromatsu, Hironori Koga, Takumi Kawaguchi Gastro Hep Advances .2024