Luteal-phase ovarian stimulation increases the number of mature oocytes in older women with severe diminished ovarian reserve

Rashtian, Justin; Zhang, Junyi

doi:10.1080/19396368.2018.1448902

Cited by 28 publications

(43 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Overall, the number of oocytes obtained and the rate of good quality embryos were higher in the LPS stage than in the FPS stage. This is consistent with previous studies [10][11][12][13][14][15][16]. Embryos obtained at the LPS stage may result in more favourable outcomes due to several factors.…”

Section: Discussionsupporting

confidence: 93%

“…There is currently limited research on DuoStim for POR [7][8][9][10][11][12][13][14][15][16]. This may be due to the fact that the traditional COS protocol is preferred in more clinical practices, as DuoStim is time-consuming and costly.…”

Section: Introductionmentioning

confidence: 99%

“…The number of eggs, metaphase II (MII) oocytes, and embryos in the cleavage stage and the rate of superior embryos is increased after the DuoStim protocol compared to the traditional COS protocol. Studies that compare the embryos obtained after the follicular phase stimulation (FPS) stage with those obtained after the luteal phase stimulation (LPS) stage in DuoStim have found that stimulation during the LPS stage results in a higher number of oocytes and embryos [10][11][12][13][14][15][16]. However, the standards for embryo evaluation data vary widely, and the conclusions of these studies are contradictory.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The best execution of the DuoStim strategy (double stimulation in the follicular and luteal phase of the same ovarian cycle) in patients who are poor ovarian responders

Luo

Sun

Dong

et al. 2020

Reprod Biol Endocrinol

View full text Add to dashboard Cite

Background Patients found to be poor ovarian responders (POR) are a challenging patient population for any assisted reproduction technology. Despite attempts at various controlled ovarian stimulation schemes, reproductive outcomes in this patient population have not improved. In recent years, the DuoStim protocol (both follicular and luteal phase stimulation during the same menstrual cycle) has shown a potential for use in patients with POR. Methods This retrospective study reviewed the medical records of 304 women who were diagnosed as POR and underwent the DuoStim protocol. We compared follicular phase stimulation (FPS) data and luteal phase stimulation (LPS) data of the same patients. We also compared the effects of different trigger drugs including urine human chorionic gonadotropin (uHCG; 10,000 IU), recombinant human chorionic gonadotropin (rHCG; 250 μg), and gonadotropin-releasing hormone agonist (GnRH-a; 0.2 mg) at the FPS and LPS stages. Results POR undergoing the DuoStim protocol resulted in a significantly higher number of oocytes retrieved, normal fertilised oocytes, cleaved embryos, cryopreserved embryos, and good quality embryos at the LPS stage than at the FPS stage. Trigger drugs at the FPS stage did not affect the FPS stage data. Regardless of the stage, rHCG and GnRH-a yielded significantly more cryopreserved embryos and good quality embryos than uHCG. Conclusion The use of GnRH-a or rHCG as the trigger drug may be better than uHCG in both the FPS and LPS stages for POR undergoing the DuoStim protocol. This will increase the number of good quality embryos at the LPS stage. We found that the LPS stage results in more oocytes (and therefore more embryos) than the FPS stage.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The best execution of the DuoStim strategy (double stimulation in the follicular and luteal phase of the same ovarian cycle) in patients who are poor ovarian responders

Luo

Sun

Dong

et al. 2020

Reprod Biol Endocrinol

View full text Add to dashboard Cite

show abstract

“…This protocol increased the number of oocytes retrieved and consequently vitrified, without delaying cancer treatment. In 2018, another two studies (50,51) demonstrated how double stimulation could be effective in patients with poor ovarian reserve. Jin et al (50) in a retrospective study compared double stimulation (Group A, n ¼ 76 poor responders) to LPSonly (Group B) and to mild ovarian stimulation (Group C).…”

Section: Updated Body Of Evidence Regarding the Clinical Implementatimentioning

confidence: 99%

“…There was no statistically significant difference between the number of oocytes retrieved. Therefore, the addition of LPS to FPS doubled the number of inseminated oocytes in a single ovarian cycle (51).…”

Section: Updated Body Of Evidence Regarding the Clinical Implementatimentioning

confidence: 99%

DuoStim – a reproducible strategy to obtain more oocytes and competent embryos in a short time-frame aimed at fertility preservation and IVF purposes. A systematic review

Vaiarelli

Cimadomo

Petriglia

et al. 2020

Upsala Journal of Medical Sciences

View full text Add to dashboard Cite

Recent evidence suggests that follicular development occurs in a wave-like model during the ovarian cycle, where up to three cohorts of follicles are recruited to complete folliculogenesis. This understanding overtakes the previous dogma stating that follicles grow only during the follicular phase of the menstrual cycle. Therefore, in in vitro fertilization (IVF), novel protocols regarding ovarian stimulation have been theorized based on the use of gonadotrophins to prompt the growth of antral follicles at any stage of the menstrual cycle. These unconventional protocols for ovarian stimulation aim at a more efficient management of poor-prognosis patients, otherwise exposed to conflicting outcomes after conventional approaches. DuoStim appears among these unconventional stimulation protocols as one of the most promising. It combines two consecutive stimulations in the follicular and luteal phases of the same ovarian cycle, aimed at increasing the number of oocytes retrieved and embryos produced in the short time-frame. This protocol has been suggested for the treatment of all conditions requiring a maximal and urgent exploitation of the ovarian reserve, such as oncological patients and poor responders at an advanced maternal age. At present, data from independent studies have outlined the consistency and reproducibility of this approach, which might also reduce the drop-out between consecutive failed IVF cycles in poor-prognosis patients. However, the protocol must be standardized, and more robust studies and cost-benefit analyses are needed to highlight the true clinical pros and cons deriving from DuoStim implementation in IVF.

show abstract

The curious case of premature luteinization

Kaponis

Chronopoulou

Decavalas

2018

J Assist Reprod Genet

View full text Add to dashboard Cite

Authors need to speak the same language when studying PL in order to facilitate comparisons. The terminology, progesterone cut-off, measurement methods and days of measurement should be standardized and globally accepted; otherwise, there can be no scientific dialog. Future research should focus on specific patient profiles that may require a tailored approach. Progesterone measurements throughout the follicular phase possibly depict the progesterone exposure better than an isolated measurement on the day of hCG. Adequately powered randomized controlled trials should confirm which the best prevention and management plan of PL is, before introducing any strategy into clinical practice.

show abstract

Luteal-phase ovarian stimulation increases the number of mature oocytes in older women with severe diminished ovarian reserve

Cited by 28 publications

References 23 publications

The best execution of the DuoStim strategy (double stimulation in the follicular and luteal phase of the same ovarian cycle) in patients who are poor ovarian responders

The best execution of the DuoStim strategy (double stimulation in the follicular and luteal phase of the same ovarian cycle) in patients who are poor ovarian responders

DuoStim – a reproducible strategy to obtain more oocytes and competent embryos in a short time-frame aimed at fertility preservation and IVF purposes. A systematic review

The curious case of premature luteinization

Contact Info

Product

Resources

About