Double ovarian stimulation
Who are the best candidates for double ovarian stimulation?
The best candidates for double ovarian stimulation or Duostim are low responders who are expected to produce three or fewer eggs. DuoStim could also benefit cancer patients needing urgent fertility preservation or patients in their 40s undergoing PGT cycles. For these patients it is vital to obtain the highest number of eggs in the shortest time. In turn, high responders who are expected to produce plenty of eggs are not good candidates.
What is the process of double ovarian stimulation?
Small follicles in the ovaries could be stimulated not only from the beginning but throughout the entire menstrual cycle. The double ovarian stimulation protocol takes advantage of this fact. It is composed of a first stimulation phase starting at the beginning of the menstrual bleeding and after a 2-3-day pause is followed by a second stimulation. In this manner, a second egg collection takes place approximately two weeks after the first one. Embryos from each egg collection need to be frozen and could be used only later. In total, the whole stimulation process could take up to one month.
What are the benefits and drawbacks of double ovarian stimulation?
Patients opting for separate IVF cycles often abandon treatment after their first attempt has failed. The chief advantage of double ovarian stimulation is reduced dropout for those who manage to complete both stimulation phases. Undergoing two stimulations could result in more eggs, more embryos, and ultimately a higher probability of success. DuoStim is a complex and long treatment; therefore, it could be hard on patients, both physically and mentally. It is mandatory to freeze embryos created from each egg collection. Clinic pricing could represent another crucial factor in whether patients choose back-to-back or separate stimulations.
What are the side-effects and risks of double ovarian stimulation?
Double ovarian stimulation does not have significantly increased rate of side effects and risks than conventional treatment. However, double ovarian stimulation is a complex and long treatment; therefore, it could be hard on patients, both physically and mentally. It is also mandatory to freeze embryos created from each egg collection and patients later need to undergo a frozen-thawed embryo transfer.
What is the success rate of double ovarian stimulation?
Success rates from double ovarian stimulation are expected to be higher than from one treatment only. A recent Italian investigation has reported a considerable increase from 8 to 15% in poor prognosis patients. It must be stressed however, that so far there are no clinical trials that have fully evaluated overall success, cost-effectiveness, patient tolerance, or safety of this new approach. Double ovarian stimulation is an innovative protocol that could be especially beneficial for low-responders and patients needing PGT cycles or fertility preservation.