Luteal-phase ovarian stimulation is a feasible method for poor ovarian responders undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer treatment compared to a GnRH antagonist protocol: A retrospective study

Wei, Lihong; Ma, Wudi; Tang, Ni; Wei, Jihong

doi:10.1016/j.tjog.2015.07.001

Cited by 21 publications

(24 citation statements)

References 17 publications

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“…The study demonstrated that luteal phase stimulation (LPS) is appropriate in producing competent oocytes, and consequently, embryos with good pregnancy outcomes, with the advantage of eradicating the ovarian hyperstimulation syndrome (OHSS) or premature luteinization. Other authors corroborated the LPS protocol feasibility ( Lin et al ., 2016 ; Wang et al ., 2016 ; Wei et al ., 2016 ), and the same group, later, described the safety for the offspring originated from that protocol ( Chen et al ., 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Can ovarian double-stimulation in the same menstrual cycle improve IVF outcomes?

Cardoso¹,

Evangelista²,

Sartório³

et al. 2017

JBRA Assisted Reproduction

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ObjectiveTo evaluate the double-stimulation protocol efficacy over conventional ovarian stimulation in recovering a more adequate number of oocytes and increase the number of embryos to be transferred or to be genetically analyzed.MethodsA retrospective and comparative study with 13 patients who underwent unsuccessful in vitro fertilization (IVF) cycles with a conventional antagonist ovarian stimulation protocol and repeat the attempt with a double stimulation protocol. The following variables were analyzed: number of oocytes collected, mature oocytes collected, fertilization rate, blastocyst rate, biopsied blastocyst rate and euploidy rate.ResultsThe double stimulation protocol had a significant higher number of oocytes collected (p=0.007) and mature oocytes to be injected (p=0.01). There was no statistically significant difference in fertilization (p=0.78) and blastocyst (p=0.59) rates.ConclusionDouble stimulation favors patients who are at risk of incurring several attempts of IVF to achieve pregnancy.

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Section: Introductionmentioning

confidence: 99%

Can ovarian double-stimulation in the same menstrual cycle improve IVF outcomes?

Cardoso¹,

Evangelista²,

Sartório³

et al. 2017

JBRA Assisted Reproduction

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“…For both stimulations, ovulation was triggered with triptorelin 0.1 ml when follicular maturation was finally achieved (8). In 2016, Wei et al (46) confirmed the same results as those of Kuang et al, with the same protocol adopted in patients aged >40 y, with a prior history of poor response defined as 3 oocytes retrieved and an antral follicle count (AFC) <6.…”

Section: Updated Body Of Evidence Regarding the Clinical Implementatimentioning

confidence: 62%

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

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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.

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“…Although there is no standard protocol for poor responder but several studies have proved better ovarian response with antagonist protocol. However the previous two studies started stimulation in the luteal phase [2,28].…”

Section: Discussionmentioning

confidence: 99%

“…Poor ovarian response to ovarian hyperstimulation is one of the biggest challenges and frustrating for both patients and clinician. Although many stimulation protocols have been used to improve outcomes in poor ovarian responders (PORs), there is a controversy which protocol is the most effective [2].…”

Section: Introductionmentioning

confidence: 99%

Role of Aromatase Inhibitor to Enhance Ovulation in Poor Responder during Induction with Short Antagonist Protocol in Cases of Intracytoplasmic Sperm Injection

Khateeb¹

2018

Gynecol Reprod Health

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Objective: Study the effect of aromataze inhibitor with short antagonist protocol to enhance ovulation response in patients expected to be poor responder undergoing ICSI. Methodology:A prospective clinical trial included all patients expected to have poor ovulation response during ovarian stimulation for ICSI. Conducted in Maternity Hospital IVF unite and two tertiary referral infertility private clinics associated with the reproductive sciences division. 50 patients were enrolled in the study divided randomly into two groups. Study group patients were offered letrozole, 2.5 mg/day from day 1-5 of the menstrual cycle with HMG300 IU/day starting on first day of the cycle with follow up by Trans vaginal ultrasound (TVUS) when at least three follicles reach 14mm diameter, GnRh antagonist given 0.25 mg SC injection daily till the day of hCG injection. HCG (10,000 IU) was given when at least three leading follicles were 18mm followed by ovum pick up. Control group offered the same management without letrozole. Main Outcome Measures:Primary outcome measure: Number of follicles reaches more than 18mm and number of metaphase II oocytes. Secondary outcome measure: clinical pregnancy rate.Results: Improved response to HMG stimulation with letrozole co-treatment was evidenced by significant number of follicles measuring more than 18mm (5.3 ± 3.5.in the study group versus 3.9 ± 1.9 in control group (p value 0.003). The number of metaphase II oocytes was significantly higher in the study group (4.6 ± 2.4 Versus3.3 ± 0.6). During letrozole co treatment clinical pregnancy was achieved in (20%) of cases. Conclusion:We demonstrated a good benefit of aromatase inhibitors for improving ovarian response to HMG in short antagonist protocol in patients expected to be poor responders.

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Luteal-phase ovarian stimulation is a feasible method for poor ovarian responders undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer treatment compared to a GnRH antagonist protocol: A retrospective study

Abstract: Compared with the GnRH-ant protocol, the LPOS protocol may be a better regime for PORs that can increase the numbers of retrieved oocytes and transferable embryos as well as the pregnancy rate.

Cited by 21 publications

References 17 publications

Can ovarian double-stimulation in the same menstrual cycle improve IVF outcomes?

Can ovarian double-stimulation in the same menstrual cycle improve IVF outcomes?

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

Role of Aromatase Inhibitor to Enhance Ovulation in Poor Responder during Induction with Short Antagonist Protocol in Cases of Intracytoplasmic Sperm Injection

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