What is the true place of a double stimulation and double oocyte retrieval in the same cycle for patients diagnosed with poor ovarian reserve? A systematic review including a meta-analytical approach

Konstantinos Sfakianoudis, Konstantinos Pantos, Sokratis Grigoriadis, Anna Rapani, Evangelos Maziotis, Petroula Tsioulou, Polina Giannelou, Adamantia Kontogeorgi, Agni Pantou, Nikolaos Vlahos, Michael Koutsilieris, Mara Simopoulou

Purpose This systematic review including a meta-analytical approach aims to investigate the safety and efficacy of employing a double ovarian stimulation (DuoStim) and a subsequent double oocyte retrieval in the same menstrual cycle, in poor ovarian reserve (POR) patients.
Methods A systematic search of literature was performed in the databases of PubMed/MEDLINE, Embase, and Cochrane Central Library up untilMarch 2019. Both prospective and retrospective cohort studies considered suitable for inclusion reported on women with POR undergoing a DuoStim in the follicular (FPS) and luteal phase (LPS) of the same menstrual cycle. Following the systematic review of the literature, a meta-analytical approach was attempted.
Results This study indicates that DuoStimis correlatedwith a higher number of retrieved oocytes,matureMII oocytes, and goodquality embryos in comparison to conventional stimulation. Additionally, LPS seems to be correlated with an equal or an even higher overall performance in comparison to FPS.
Conclusion DuoStim favors an enhanced clinical outcome in regard to the total number of yielded oocytes, mature oocytes, and available embryos, along with the quality of obtained embryos. Sourced data indicate that LPS is not correlated with a higher aneuploidy rate. This option may present as promising for the time-sensitive nature of POR patients’ management, by enabling a higher oocyte yield during a single menstrual cycle.

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