Investigating Ovulation Induction Outcomes in Patients with Decreased Ovarian Reserve Treated with Double Stimulation during The Follicular and Luteal Phases Compared to The Conventional Antagonist Cycle: A Randomized Clinical Trial

Document Type : Original Article


1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran

2 Department of Biostatistics and Epidemiology, Infectious Diseases and Tropical Medicine Research Centre, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran

3 Department of Obstetrics, Gynaecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Obstetrics and Gynaecology, Molud Infertility Centre, Zahedan University of Medical Sciences, Zahedan, Iran

5 Pregnancy Health Research Centre, Zahedan University of Medical Sciences, Zahedan, Iran

6 Cellular and Molecular Research Centre, Research Institute of Cellular and Molecular Science in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran


Background: It is difficult to obtain healthy oocytes in poor ovarian responders with conventional treatment methods.
Thus, the need to investigate new methods is essential. This study aims to investigate ovulation induction outcomes
in patients with decreased ovarian reserve (DOR) in two groups treated with double stimulation (DuoStim) during the
follicular and luteal phases in comparison with the antagonist cycle.
Materials and Methods: This was a randomised clinical trial that enrolled the patients with reduced ovarian reserve. The
patients referred for in vitro fertilisation (IVF) at Molud Infertility Clinic, Ali Ebn Abitalib (AS) Hospital, Zahedan, Iran
from 2020 to 2021. Participants were randomly divided into two groups, those who underwent treatment with DuoStim
during the follicular and luteal phase (case group) and those who received the conventional antagonist cycle (control group).
Results: The mean number of metaphase II (MII) eggs was 7.7 ± 3.1 in the case group and 6.1 ± 3.9 in the control
group (P=0.063). The mean total number of retrieved eggs in the case group was 9.2 ± 3.7 and in the control group, it
was 6.9 ± 4.4 (P=0.023). The mean number of embryos obtained in the case group was 6.5 ± 3.9; in the control group,
it was 4.7 ± 2.8 (P=0.016).
Conclusion: The DuoStim method can effectively play a role in increasing the total number of retrieved eggs and embryos
(registration number: IRCT20120817010617N8).



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