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

Document Type : Original Article


1 Preventive Gynecology Research Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Preventive Gynecology Research Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


Background: Various protocols have been approved to improve the response rate leading to successful fertilization
in poor ovarian responders (PORs). The application of double ovarian stimulation (DuoStim) in the follicular and
luteal phases of the same ovarian cycle has been shown as an intriguing option to achieve more oocyte retrievals in
the 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) candidates
with POR diagnosis. Patients were classified into two equal groups and treated with the DuoStim protocol and MS
protocol. The IVF outcomes, including retrieved follicles, oocytes, metaphase II (MII) oocytes and embryos, were
compared 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 was
no significant difference between the two groups' baseline characteristics (P>0.05). We observed that the DuoStim
protocol 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 single
stimulation cycle. The DuoStim protocol significantly can result in more frequent MII oocytes and embryos. We figured
that the higher number of oocytes and embryos might have led to a higher rate of pregnancy (registration number:


Main Subjects

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