{"title":"Comparison <i>In Vitro</i> Fertilization Outcomes between DouStim and Minimal Stimulation Protocols in Poor Ovarian Responders: A Randomized Clinical Trial.","authors":"Nasrin Saharkhiz, Saghar Salehpoor, Sedigheh Hosseini, Leila Nazari, Samaneh Sheibani, Tahereh Doohandeh","doi":"10.22074/ijfs.2023.552687.1293","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Various protocols have been approved to improve the response rate leading to successful fertilization in poor ovarian responders (PORs). The application of double ovarian stimulation (DuoStim) in the follicular and luteal phases of the same ovarian cycle has been shown as an intriguing option to achieve more oocyte retrievals in the shortest time. The aim of the current study is to compare the outcomes of different protocols, minimal stimulation (MS) and Duostim.</p><p><strong>Materials and methods: </strong>This randomized clinical trial was performed on 42 <i>in vitro</i> fertilization (IVF) candidates with POR diagnosis. Patients were classified into two equal groups and treated with the DuoStim protocol and MS protocol. The IVF outcomes, including retrieved follicles, oocytes, metaphase II (MII) oocytes and embryos, were compared between these groups.</p><p><strong>Results: </strong>The patients' characteristics including age, anti-mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), and antral follicle count (AFC) were collected and compared. It showed there was no significant difference between the two groups baseline characteristics (P>0.05). We observed that the DuoStim protocol resulted in a significantly higher score in comparison with the MS protocols , including the number of follicles (6.23 ± 2.93 vs. 1.77 ± 1.66, P<0.001), retrieved oocytes (3.86 ± 2.57 vs. 1.68 ± 1.58, P=0.002), MII oocytes (3.36 ± 2.42 vs. 1.27 ± 1.27, P=0.001) and obtained embryos (2.04 ± 1.64 vs. 0.77 ± 0.86, P=0.003).</p><p><strong>Conclusion: </strong>The DuoStim protocol is a favourable and time saving plan that is associated with more oocytes in a single stimulation cycle. The DuoStim protocol significantly can result in more frequent MII oocytes and embryos. We figured that the higher number of oocytes and embryos might have led to a higher rate of pregnancy (registration number: IRCT20200804048303N1).</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"18 2","pages":"135-139"},"PeriodicalIF":2.3000,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10875315/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Fertility & Sterility","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22074/ijfs.2023.552687.1293","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
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Abstract
Background: Various protocols have been approved to improve the response rate leading to successful fertilization in poor ovarian responders (PORs). The application of double ovarian stimulation (DuoStim) in the follicular and luteal phases of the same ovarian cycle has been shown as an intriguing option to achieve more oocyte retrievals in the shortest time. The aim of the current study is to compare the outcomes of different protocols, minimal stimulation (MS) and Duostim.
Materials and methods: This randomized clinical trial was performed on 42 in vitro fertilization (IVF) candidates with POR diagnosis. Patients were classified into two equal groups and treated with the DuoStim protocol and MS protocol. The IVF outcomes, including retrieved follicles, oocytes, metaphase II (MII) oocytes and embryos, were compared between these groups.
Results: The patients' characteristics including age, anti-mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), and antral follicle count (AFC) were collected and compared. It showed there was no significant difference between the two groups baseline characteristics (P>0.05). We observed that the DuoStim protocol resulted in a significantly higher score in comparison with the MS protocols , including the number of follicles (6.23 ± 2.93 vs. 1.77 ± 1.66, P<0.001), retrieved oocytes (3.86 ± 2.57 vs. 1.68 ± 1.58, P=0.002), MII oocytes (3.36 ± 2.42 vs. 1.27 ± 1.27, P=0.001) and obtained embryos (2.04 ± 1.64 vs. 0.77 ± 0.86, P=0.003).
Conclusion: The DuoStim protocol is a favourable and time saving plan that is associated with more oocytes in a single stimulation cycle. The DuoStim protocol significantly can result in more frequent MII oocytes and embryos. We figured that the higher number of oocytes and embryos might have led to a higher rate of pregnancy (registration number: IRCT20200804048303N1).
背景：为提高卵巢反应不良者（PORs）成功受精的反应率，已有多种方案获得批准。在同一卵巢周期的卵泡期和黄体期应用双重卵巢刺激（DuoStim）已被证明是在最短时间内获得更多卵母细胞的有趣选择。本研究旨在比较不同方案、最小刺激（MS）和双刺激（Duostim）的结果：这项随机临床试验针对 42 名诊断为 POR 的体外受精（IVF）候选人。患者被分为两组，分别接受 DuoStim 方案和 MS 方案治疗。比较了两组患者的体外受精结果，包括取回的卵泡、卵母细胞、分裂期 II（MII）卵母细胞和胚胎：结果：收集并比较了患者的特征，包括年龄、抗苗勒氏激素（AMH）、促卵泡激素（FSH）、黄体生成素（LH）和前卵泡计数（AFC）。结果显示，两组基线特征无明显差异（P>0.05）。我们观察到，与 MS 方案相比，DuoStim 方案的得分明显更高，包括卵泡数（6.23 ± 2.93 vs. 1.77 ± 1.66，PC结论：DuoStim方案是一种省时省力的好方案，可在一个刺激周期内获得更多卵母细胞。DuoStim 方案能显著增加 MII 卵母细胞和胚胎的数量。我们认为，更多的卵母细胞和胚胎可能会导致更高的妊娠率（注册号：IRCT20200804048303N1）。
期刊介绍：
International Journal of Fertility & Sterility is a quarterly English publication of Royan Institute . The aim of the journal is to disseminate information through publishing the most recent scientific research studies on Fertility and Sterility and other related topics. Int J Fertil Steril has been certified by Ministry of Culture and Islamic Guidance in 2007 and was accredited as a scientific and research journal by HBI (Health and Biomedical Information) Journal Accreditation Commission in 2008. Int J Fertil Steril is an Open Access journal.
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