Double Ovarian Stimulation as Accumulation Strategy for Older Infertile Patients With Suboptimal Ovarian Response
Status:
Unknown status
Trial end date:
2019-05-01
Target enrollment:
Participant gender:
Summary
Patients with infertility of the older age group of 37-42 years - a large cohort of patients
of reproductive medicine. Two possible causes reduce their probability of pregnancy - an
increasing age and a decrease of the ovarian reserve. In these conditions, the early receipt
of embryos for future transfer can serve as a correct strategy for treating infertility in
this category of patients. According to statistical data, patients of the 37-42-year-old age
group need 3-5 blastocysts, out of them 1-2 euploid to achieve pregnancy.
The POSEIDON group of researchers identified a group of 2b patients with a suboptimal
response to the induction of superovulation in IVF programs - patients older than 35 years
with a normal ovarian reserve (the number of antral follicles greater than 5 and
Anti-Müllerian hormone (AMH) greater than 1.2 ng / ml), resulting in 4-9 oocytes after a
standard ovarian stimulation.
In this situation standard stimulation protocols can stretch the process of obtaining embryos
indefinitely, during which the patient will move to another age category with a decrease in
the likelihood of pregnancy.
Thus, these patients are shown the fastest reception of oocytes and the accumulation of
embryos, which can be done using double ovarian stimulation in the same menstrual cycle.
The aim of the study is to compare the different schemes of double stimulation in patients
with infertility of the older age group of 37-42 years with the preceding suboptimal
response.
Group 1 - patients of the DUOSTIM group. Group 2 - Patients of the Shanghai Protocol.
The investigated parameters - primary outcome measures: total number of retrieved oocytes per
cycle, secondary outcome measures: total number of blastocyst per cycle, number of cycles
with double ovarian stimulation required to obtain 3-5 blastocyst, time until embryo
transfer, pregnancy rate and birth rate This is a prospective randomized non-blinded clinical
study.