Influence of the Starting Day of Luteal Phase Stimulation on Double Stimulation Cycles

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2023 Aug 2

PMID 37529596

Authors

Ana Fuentes

Cristina Garcia-Ajofrin

Ruth Romero

Juan Carlos Castillo

Jose A Ortiz

Monica Hortal

Jaime Guerrero

Andrea Bernabeu

Rafael Bernabeu

Affiliations

Soon will be listed here.

Abstract

Background: Double ovarian stimulation is one of the most used strategies in poor-prognosis patients. There is a high heterogeneity between the studies regarding the execution of this stimulation protocol. The aim of this study was to investigate whether the day on which luteal phase stimulation begins after the first oocyte retrieval affects ovarian response in DuoStim cycles.

Methods: This observational and retrospective study included 541 DuoStim cycles between January 2018 and December 2021 in a private fertility clinic. Patients were assigned to 4 groups according to the timing of the onset of luteal phase stimulation after oocyte retrieval (0-2 day, 3 day, 4 day and 5-6 day). The primary outcome was the number of oocytes retrieved in the luteal phase in each group.

Results: No differences were found between groups in the number of oocytes collected (5.12 ± 3.56 vs. 5.39 ± 3.74 vs. 5.61 ± 3.94 vs. 5.89 ± 3.92; p=0,6), MII or number of follicles. An increase in the duration of stimulation was found when stimulation started on the 4 day (10.42 ± 2.31 vs. 10.68 ± 2.37 vs. 11.27 ± 2.40 vs. 10.65 ± 2.37 days, p=0,033). A lower number of fertilized oocytes was observed when stimulation began before the fourth day (3.36 ± 2.80 vs. 3.95 ± 2.53 vs. 4.03 ± 2.73 vs. 4.48 ± 3.11; p=0,036). The number of blastocysts was higher when the stimulation started 5-6 days after retrieval (1.82 ± 1.74 vs. 2.13 ± 1.61 vs. 2.33 ± 2.06 vs. 2.91 ± 2.39; p= 0,030).

Discussion: The number of oocytes retrieved does not differ depending on the day that stimulation begins. However, oocytes competence in terms of fertilized oocytes and blastulation, appears to be lower when the second stimulation starts before the fourth day after oocyte retrieval.

Citing Articles

The impact of Duostim protocol on pregnancy outcomes in infertile patients: A meta-analysis comparing single and double conventional stimulation cycles.

Zeng Y, Liu W, Luo Y, Luo B, Zhu L, Yang Z J Assist Reprod Genet. 2024; 41(12):3455-3466.

PMID: 39601990 PMC: 11707166. DOI: 10.1007/s10815-024-03304-5.

A multicycle approach through DuoStim with a progestin-primed ovarian stimulation (PPOS) protocol: a valuable option in poor prognosis patients undergoing PGT-A.

Vaiarelli A, Pittana E, Cimadomo D, Ruffa A, Colamaria S, Argento C J Assist Reprod Genet. 2024; 42(1):255-264.

PMID: 39538089 PMC: 11805732. DOI: 10.1007/s10815-024-03317-0.

Continuous ovarian stimulation: a proof-of-concept study exploring the uninterrupted use of corifollitropin α in DuoStim cycles for enhanced efficiency and patient convenience (Alicante protocol).

Castillo J, Fuentes A, Ortiz J, Abellan E, Bernabeu A, Bernabeu R F S Rep. 2024; 5(2):176-182.

PMID: 38983736 PMC: 11228776. DOI: 10.1016/j.xfre.2024.03.005.

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