Comparison In Vitro Fertilization Outcomes between DouStim and Minimal Stimulation Protocols in Poor Ovarian Responders: A Randomized Clinical Trial

Abstract

Background: Various protocols have been approved to improve the response rate leading to successful fertilizationin poor ovarian responders (PORs). The application of double ovarian stimulation (DuoStim) in the follicular andluteal phases of the same ovarian cycle has been shown as an intriguing option to achieve more oocyte retrievals inthe 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) candidateswith POR diagnosis. Patients were classified into two equal groups and treated with the DuoStim protocol and MSprotocol. The IVF outcomes, including retrieved follicles, oocytes, metaphase II (MII) oocytes and embryos, werecompared 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 wasno significant difference between the two groups' baseline characteristics (P>0.05). We observed that the DuoStimprotocol 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 singlestimulation cycle. The DuoStim protocol significantly can result in more frequent MII oocytes and embryos. We figuredthat the higher number of oocytes and embryos might have led to a higher rate of pregnancy (registration number:IRCT20200804048303N1).

Keywords

• clinical protocol
• in vitro fertilization
• oocyte retrieval
• ovarian follicle
• ovulation induction