Comparison of Dual Stimulation IVF-ICSI in one cycle with IVF-ICSI in two separate cycles in Poor Responder Patients

Abstract

Since time is very important for these patients, one of the most crucial methods is to increase the number of oocytes obtained by stimulating ovulation in a short period. Stimulating ovulation twice in one cycle reduces the time needed to obtain more eggs and increases the probability of acquiring a healthy egg. Since these patients use previous complementary treatments to start the IVF cycle, compared to ovulation stimulation in two cycles (which are often not consecutive due to the presence of ovarian cysts), the duration of using these drugs is also reduced in the mentioned method. The purpose of this study is to compare Dual Stimulation in IVF-ICSI of poor responder patients with IVF-ICSI in two separate cycles. Material and Methods: This clinical trial study was conducted to evaluate the results of IVF-ICSI by two different methods in infertile women with primary infertility referred to the infertility center of Alzahra Hospital, Milad Clinic, Tabriz, who were considered to have low ovarian reserve and poor responders to treatment according to the Bologna criteria. The two desired methods include stimulation of ovulation in the follicular phase and luteal phase of a menstrual cycle (dual stimulation) and stimulation of ovulation in two separate cycles. The two groups were compared in terms of the number and quality of oocytes harvested, the number and quality of embryos, the dose of gonadotropin used, and the result of embryo transfer. Results: In the first stimulation, the number of POST mature oocytes in control group patients was significantly higher than intervention group patients (P=0.035). Also, the mean number of normal or amorphous oocytes in the participants of the intervention group was significantly higher than in the participants of the control group (P=0.042). Out of the total number of normal oocytes in the participants of the intervention group, 2 [1-3] embryos were obtained, while this number was equal to 1 [2-1] embryos in the participants of the control group (P=0.035). In the second stimulation, the number of POST mature oocytes in the patients of the control group was insignificantly higher than in the patients of the intervention group (P=0.089). The average number of normal or amorphous oocytes in the participants of the intervention group was insignificantly higher than in the participants of the control group (P=0.115). Out of the total number of normal oocytes in the participants of the intervention group, 2 embryos [1-4] were obtained, while this number was equal to 2 embryos [1-3] in the participants of the control group (P=0.415). Among all the participants in the intervention group, 7 people (35%) had extra embryos for the next transfer, while only 3 people (15%) of the control group had extra embryos for the next transfer.