Comparison of intracytoplasmic sperm injection and in vitro fertilization outcomes in double stimulation with conventional protocol in participants with poor ovarian response with minimal injection: An RCT.

Abstract

Background: In women with poor ovarian response (POR), the quantity and quality of oocytes produced by the ovaries decrease, resulting in poor-quality embryos. Ovarian stimulation, by increasing the number of oocytes and embryos, improves in vitro fertilization (IVF) outcomes.

Objective: The aim of this study was to compare intracytoplasmic sperm injection and IVF outcomes in double stimulation (DuoStim) with a conventional protocol in participants with POR and minimal injection.

Materials and methods: This randomized clinical trial was conducted on 90 women with POR referred for IVF treatment at female infertility unit, Arash Women's hospital, Tehran University of Medical Sciences, Tehran, Iran. Women were randomly assigned to either the DuoStim group, which underwent ovarian stimulation during both the follicular and luteal phases (n = 45) or the conventional group (n = 45). Finally, the number of recovered metaphase II oocytes and the number of oocytes retrieved were measured.

Results: The mean number of metaphase II eggs was 5.7 $\pm$ 3.9 in the DuoStim group and 6.2 $\pm$ 3.9 in the conventional group (p = 0.53). The mean total number of retrieved eggs in the DuoStim group was 7.2 $\pm$ 4.5, and in the conventional group, it was 9.7 $\pm$ 6.04 (p = 0.026). The mean number of embryos obtained in the DuoStim group was 4.5 $\pm$ 3.9; in the conventional group, it was 4.7 $\pm$ 2.8 (p = 0.016).

Conclusion: In our study, the number of oocytes retrieved and the duration of ovarian stimulation were lower in the DuoStim group than the conventional group, and we reached the same number of oocytes and high-quality embryos in a shorter time.