What is the true place of a double stimulation and double oocyte retrieval in the same cycle for patients diagnosed with poor ovarian reserve? A systematic review including a meta-analytical approach
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This systematic review including a meta-analytical approach aims to investigate the safety and efficacy of employing a double ovarian stimulation (DuoStim) and a subsequent double oocyte retrieval in the same menstrual cycle, in poor ovarian reserve (POR) patients.
A systematic search of literature was performed in the databases of PubMed/MEDLINE, Embase, and Cochrane Central Library up until March 2019. Both prospective and retrospective cohort studies considered suitable for inclusion reported on women with POR undergoing a DuoStim in the follicular (FPS) and luteal phase (LPS) of the same menstrual cycle. Following the systematic review of the literature, a meta-analytical approach was attempted.
This study indicates that DuoStim is correlated with a higher number of retrieved oocytes, mature MII oocytes, and good-quality embryos in comparison to conventional stimulation. Additionally, LPS seems to be correlated with an equal or an even higher overall performance in comparison to FPS.
DuoStim favors an enhanced clinical outcome in regard to the total number of yielded oocytes, mature oocytes, and available embryos, along with the quality of obtained embryos. Sourced data indicate that LPS is not correlated with a higher aneuploidy rate. This option may present as promising for the time-sensitive nature of POR patients’ management, by enabling a higher oocyte yield during a single menstrual cycle.
KeywordsLuteal phase stimulation Follicular phase stimulation Double stimulation DuoStim Poor ovarian response
The authors are very appreciative to all clinicians, embryologists, and scientists at the Centre for Human Reproduction at Genesis Hospital and at the Department of Physiology of the National and Kapodistrian University of Athens Medical School.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Groome NP, Illingworth PJ, O’Brien M, Pai R, Rodger FE, Mather JP, et al. Measurement of dimeric inhibin B throughout the human menstrual cycle. J Clin Endocrinol Metab. 1996;81:1401–5.Google Scholar
- 8.Sfakianoudis K, Simopoulou M, Maziotis E, Giannelou P, Tsioulou P, Rapani A, et al. Evaluation of the second follicular wave phenomenon in natural cycle assisted reproduction: a key option for poor responders through luteal phase oocyte retrieval. Medicina (Kaunas). 2019;55:68.CrossRefGoogle Scholar
- 9.Ubaldi FM, Capalbo A, Vaiarelli A, Cimadomo D, Colamaria S, Alviggi C, et al. Follicular versus luteal phase ovarian stimulation during the same menstrual cycle (DuoStim) in a reduced ovarian reserve population results in a similar euploid blastocyst formation rate: new insight in ovarian reserve exploitation. Fertil Steril. 2016;105:1488–1495.CrossRefGoogle Scholar
- 10.Vaiarelli A, Cimadomo D, Trabucco E, Vallefuoco R, Buffo L, Dusi L, et al. Double stimulation in the same ovarian cycle (DuoStim) to maximize the number of oocytes retrieved from poor prognosis patients: a multicenter experience and SWOT analysis. Frontiers in Endocrinology. Frontiers; 2018;9:317.Google Scholar
- 17.Martazanova B, Mishieva N, Bogatyreva K, Veyukova M, Kodileva T, Burmenskaya O, et al. Double stimulation in a single menstrual cycle in patients with reduced ovarian reserve: hormonal characteristics, cumulus cell gene expression, embryological and clinical outcome. Human Reproduction. Oxford Univ Press Great Clarendon St, Oxford OX2 6DP, England; 2018. p. 80.Google Scholar
- 18.de Almeida Cardoso MC, Evangelista A, Sartório C, Vaz G, Werneck CLV, Guimarães FM, et al. Can ovarian double-stimulation in the same menstrual cycle improve IVF outcomes? JBRA Assisted Reproduction. 2017;21:217.Google Scholar
- 22.Zhang W, Wang M, Wang S, Bao H, Qu Q, Zhang N, et al. Luteal phase ovarian stimulation for poor ovarian responders. JBRA Assist Reprod. 2018;22:193.Google Scholar
- 25.Campos APCB, Geber GP, Hurtado R, Sampaio M, Geber S. Ovarian response after random-start controlled ovarian stimulation to cryopreserve oocytes in cancer patients. JBRA Assist Reprod. 2018;22:381.Google Scholar
- 26.Tsampras N, Gould D, Fitzgerald CT. Double ovarian stimulation (DuoStim) protocol for fertility preservation in female oncology patients. Hum Fertil. Taylor & Francis. 2017;20:248–53.Google Scholar
- 27.Leahomschi S. Duostim protokol v managementu a léčbě pacientek s nízkou odpovědí na kontrolovanou ovariální hyperstimulaci. 2018;Google Scholar
- 28.Cimadomo D, Vaiarelli A, Colamaria S, Trabucco E, Alviggi C, Venturella R, et al. Luteal phase anovulatory follicles result in the production of competent oocytes: intra-patient paired case-control study comparing follicular versus luteal phase stimulations in the same ovarian cycle. Hum Reprod. 2018;33:1442–8.CrossRefGoogle Scholar
- 29.Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ [Internet]. 2016 [cited 2019 Oct 13];355. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062054/