{"id":102785,"date":"2021-06-30T14:41:13","date_gmt":"2021-06-30T12:41:13","guid":{"rendered":"https:\/\/www.ivi.uk\/?p=102785"},"modified":"2022-04-12T17:37:24","modified_gmt":"2022-04-12T15:37:24","slug":"duostim-the-ivf-stimulation-protocol-designed-for-low-ovarian-reserves","status":"publish","type":"post","link":"https:\/\/www.ivi.uk\/blog\/duostim-the-ivf-stimulation-protocol-designed-for-low-ovarian-reserves\/","title":{"rendered":"DuoStim: the IVF stimulation protocol designed for low ovarian reserves"},"content":{"rendered":"<ul>\n<li><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">The DuoStim protocol consists of stimulating the ovaries at two different stages within a single menstrual cycle<\/span><\/span><\/strong><\/li>\n<li><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">IVI is the first to compare DuoStim results with those of two conventional non-consecutive stimulations, which found a near 50% reduction in the amount of time required to obtain a healthy embryo<\/span><\/span><\/strong><\/li>\n<li><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">DuoStim is proposed as a major advance for patients with poorer prognoses, who may need to accumulate oocytes, and embryos, to perform pre-implantation genetic testing\n<p>\n<\/span><\/span><\/strong><\/li>\n<\/ul>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">At the <\/span><\/span><a href=\"https:\/\/www.eshre.eu\/ESHRE2021\"><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">37<span style=\"font-size: 13.3333px;\">th <\/span><\/span><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Annual Congress of the European Society of Human Reproduction and Embryology (ESHRE)<\/span><\/span><\/strong><\/a><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">, IVI presented <\/span><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">a pioneering new study analysing the DuoStim protocol: a treatment protocol consisting of two consecutive ovarian stimulations within a single menstrual cycle.<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">For the first time in a clinical research setting, outcomes of double ovarian stimulation (DuoStim) were compared with those obtained with two non-consecutive conventional stimulations. <\/span><span style=\"vertical-align: inherit;\">Between these two treatment protocols, the study found meaningful differences, specifically in terms of the <\/span><\/span><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">time taken to achieve <\/span><\/span><\/strong><strong><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">\u00a0a<\/span><\/span><\/strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"> healthy embryo. <\/span><\/span><\/strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">The research demonstrated that DuoStim shortened the time between undergoing ovarian stimulation to achieving a healthy (euploid) embryo by 50%.<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">For patients for whom time is a more critical factor in their outcomes, this protocol is a highly effective tool to accumulate both oocytes, and embryos, in a much shorter amount of time when compared with conventional phases of ovarian stimulation.<\/span><\/span><\/p>\n<p>&nbsp;<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_68_1 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title \" >Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.ivi.uk\/blog\/duostim-the-ivf-stimulation-protocol-designed-for-low-ovarian-reserves\/#Double_stimulation_for_patients_with_low_ovarian_reserves\" title=\"Double stimulation for patients with low ovarian reserves\">Double stimulation for patients with low ovarian reserves<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.ivi.uk\/blog\/duostim-the-ivf-stimulation-protocol-designed-for-low-ovarian-reserves\/#Healthy_embryos_in_half_the_time\" title=\"Healthy embryos in half the time\">Healthy embryos in half the time<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.ivi.uk\/blog\/duostim-the-ivf-stimulation-protocol-designed-for-low-ovarian-reserves\/#A_fundamental_tool_to_achieve_the_greatest_number_of_healthy_embryos\" title=\"A fundamental tool to achieve the greatest number of healthy embryos\">A fundamental tool to achieve the greatest number of healthy embryos<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Double_stimulation_for_patients_with_low_ovarian_reserves\"><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Double stimulation for patients with low ovarian reserves<\/span><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">On Tuesday 29th July 2021, Dr Mar\u00eda Cerrillo, Consultant Gynecologist at <\/span><\/span><a href=\"https:\/\/ivi-fertilite.fr\/cliniques\/madrid\/\"><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">IVI Madrid<\/span><\/span><\/a><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">, presented to study to ESHRE entitled: \u201cThe DuoStim strategy shortens the time to obtain an euploid embryo in poor prognosis patients: a non-inferiority randomized controlled trial\u201d.<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">The DuoStim strategy is a solution designed primarily for <\/span><\/span><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">female <\/span><\/span><\/strong> <strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">patients who respond poorly to controlled ovarian stimulation<\/span><\/span><\/strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">. <\/span><span style=\"vertical-align: inherit;\">In such cases, the ovaries produce fewer eggs than required to proceed in a fertility treatment and may indicate a higher dose of stimulation is needed. <\/span><span style=\"vertical-align: inherit;\">For these patients, it is important to accumulate as many oocytes as possible. <\/span><span style=\"vertical-align: inherit;\">The DuoStim regime may also be particularly beneficial for those recommended to screen embryos using <\/span><\/span><a href=\"https:\/\/www.ivi.uk\/assisted-reproduction-treatments\/ivf-genetic-screening\/\"><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Pre-Implantation Genetic Testing for Aneuploidy (PGT-A)<\/span><\/span><\/a><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"> , such as women of advanced maternal age or with a history of recurring miscarriage or unsuccessful IVF treatment. <\/span><span style=\"vertical-align: inherit;\">In these circumstances, it is optimal that the highest number of embryos are achieved in a shorter time.<\/span><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"> Optimising the time taken to obtain oocytes and embryos is therefore essential for patients with more severe prognoses, in order to improve the likelihood of achieving a healthy pregnancy and live birth.<\/span><\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Healthy_embryos_in_half_the_time\"><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Healthy embryos in half the time<\/span><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">In order to carry out this study, 80 patients were initially recruited. <\/span><span style=\"vertical-align: inherit;\">The characteristics of the patients were very similar: over the age of 38 years old, mean AMH 0.92, similar BMI and similar antral follicle count (AFC). <\/span><span style=\"vertical-align: inherit;\">Each patient had previously been recommended to consider <\/span><\/span><a href=\"https:\/\/www.ivi.uk\/assisted-reproduction-treatments\/ivf-genetic-screening\/\"><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">pre-implantation genetic testing<\/span><\/span><\/a><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"> due to their specific circumstances. <\/span><span style=\"vertical-align: inherit;\">From these patients, 54 were selected for the study. <\/span><span style=\"vertical-align: inherit;\">Two groups were then formed, with 27 patients in each group: one group following the DuoStim protocol and the other undergoing two non-consecutive conventional stimulations. <\/span><span style=\"vertical-align: inherit;\">IVI began to analyse the effects of the different ovarian stimulation protocols to compare the time required to achieve healthy embryos.\u00a0<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">\u201c<em>Upon comparing the results of these two groups, we were able to verify that there were no differences in the days on which the two stimulations were performed, nor in the number of oocytes or embryos obtained. <\/em><\/span><em><span style=\"vertical-align: inherit;\">The main difference was in the amount of time taken to find a healthy embryo. <\/span><\/em><span style=\"vertical-align: inherit;\"><em>In the case of the patients stimulated with DuoStim, the time to achieve an euploid embryo was 23.3 days, versus 44.1 days in the group of patients who had two conventional non-consecutive stimulations<\/em>, &#8221; indicates Dr Mar\u00eda Cerrillo.<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">\u201c<em>Medical literature has already provided studies and data which analyses the results of two consecutive ovarian stimulations for specific patient groups. <\/em><\/span><em><span style=\"vertical-align: inherit;\">However, IVI is the first to conduct a comparison of two stimulations carried out during one menstrual cycle with two stimulations carried out during two different menstrual cycles. <\/span><span style=\"vertical-align: inherit;\">Furthermore, the purpose of DuoStim was born from the observation that <\/span><\/em><\/span><em><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">the oocytes obtained outside the follicular phase are just as usable and viable<\/span><\/span><\/strong><\/em><span style=\"vertical-align: inherit;\"><em><span style=\"vertical-align: inherit;\">. <\/span><\/em><span style=\"vertical-align: inherit;\"><em>The conclusion was that patients stimulated with the DuoStim protocol were able to reduce the time necessary to obtain a healthy embryo for transfer by half, therefore making a reduction in the time to achieve pregnancy more likely,<\/em> \u201d added Dr. Cerrillo.<\/span><\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span class=\"ez-toc-section\" id=\"A_fundamental_tool_to_achieve_the_greatest_number_of_healthy_embryos\"><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">A fundamental tool to achieve the greatest number of healthy embryos<\/span><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">When conducting this study, three common questions occurred:<\/span><\/span><\/p>\n<ul>\n<li><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">How do we mature the oocytes in order to schedule the egg collections?<\/span><\/span><\/li>\n<li><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Is it necessary to extract the smallest oocytes at the time of the first egg collection?<\/span><\/span><\/li>\n<li><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">How long do we have to wait between the first egg collection and the second stimulation?\u00a0<\/span><\/span><\/li>\n<\/ul>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Between the stimulation phases, IVI researchers waited five days before starting the second stimulation phase following the first egg collection.\u00a0<\/span><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">While the characteristics of the patients in the two groups were very similar, there was little difference in the cycles between the two groups in terms of the dose of gonadotropin, days of stimulation, fertilization rate, blastocyst rate, implantation rate and pregnancy rate. <\/span><span style=\"vertical-align: inherit;\">The crucial difference was in the time required to obtain an euploid embryo with a normal or healthy chromosomal composition, where time was reduced by almost half.\u00a0\u00a0\u00a0<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">\u201c<\/span><\/span><em><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">DuoStim is proposed as a fundamental tool for those who need to accumulate oocytes in order to achieve the largest number of healthy embryos for the purpose of performing pre-implantation genetic testing, which for some patients, is strongly recommended. <\/span><span style=\"vertical-align: inherit;\">For patients with specific circumstances which present more difficult fertility challenges, such as poor responders, this protocol could also save very valuable time <\/span><\/span><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">&#8211; time which many of our patients do not always have<\/span><\/span><\/em><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">,\u201d Dr. Cerrillo notes.<\/span><\/span><\/p>\n<p>For more information, please contact <a href=\"mailto:Press.UK@ivirma.com\">Press.UK@ivirma.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"The DuoStim protocol consists of stimulating the ovaries at two different stages within a single menstrual cycle IVI is the first to compare DuoStim results with those of two conventional non-consecutive stimulations, which found a near 50% reduction in the amount of time required to obtain a healthy embryo DuoStim is proposed as a major&#8230; <a class=\"view-article\" href=\"https:\/\/www.ivi.uk\/blog\/duostim-the-ivf-stimulation-protocol-designed-for-low-ovarian-reserves\/\">View Article<\/a>","protected":false},"author":1,"featured_media":103128,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[220,335],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - 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