Comparison of clinical outcomes among dual ovarian stimulation, mild stimulation and luteal phase stimulation protocols in women with poor ovarian response

Abstract

This study aimed to determine whether consecutive ovarian stimulation in follicular and luteal phases within a single menstrual cycle (dual stimulation) is achievable and superior to conventional stimulation for poor ovarian responders (PORs). Data of 260 PORs were retrospectively collected and divided into three groups. Group A comprised of cycles with dual ovarian stimulation (n = 76), which were divided into two subgroups (follicular [group A-F] and luteal phase stimulation [group A-L]); group B comprised of cycles with ovarian stimulation that was performed only in the luteal phase (n = 52). Group C comprised of mild ovarian stimulation cycles (n = 132). Baseline parameters were not different among the three groups. The numbers of oocytes and embryo obtained were less in group A-F than group B and C, while group A overall had significantly more oocytes and viable embryo retrieved than did group B and C. Group A-L consumed significantly less gonadotropin than group B, without compromising the number of retrieved oocytes and embryo. The pregnancy outcomes of transfer of embryo from different stimulation phases were similar. We conclude that dual ovarian stimulation protocol is effective and potentially optimal for PORs.

Chinese abstract

卵巢低反应患者应用双刺激方案、微刺激方案及黄体期促排方案的临床结果比较

摘要

本研究旨在确定卵巢低反应（PORs）患者在一次月经周期的卵泡期和黄体期中, 对卵巢进行连续性刺激是否可行以及是否优于常规刺激。回顾性收集260例PORs患者, 分为3组。A组分为两个亚组（卵泡期刺激[A-F组]和黄体期刺激[A-L组]）, 均采用双刺激方案（n = 76）, B组仅在黄体期进行卵巢刺激（n = 52）, C组采用微刺激方案（n = 132）。三组的基线参数没有差异。A-F组获得的卵母细胞和胚胎数量少于B组和C组, 而A组整体卵母细胞数和可复苏的胚胎数量却明显高于B组和C组。除了比较卵母细胞及胚胎数量外, A-L组消耗的促性腺激素明显少于B组。而经不同刺激方案获得胚胎后移植的妊娠率却相似。因此得出结论双刺激方案是有效的, 可能是PORs患者的最佳选择。

关键词: 卵巢低反应, 双刺激, 体外受精

Keywords:

• Poor ovarian responders
• dual ovarian stimulation
• in vitro fertilization

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [81771656, 81370763].