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.

Farzipour S, Kashani L, Khodarahmian M, Kasra Jafari, Moini A
International journal of reproductive biomedicine · 2025 · doi:10.18502/ijrm.v23i12.20716 · PMID:41783731 · PMC12926649
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-28 ⓘ

This RCT found that the DuoStim protocol retrieved fewer oocytes than the conventional protocol but yielded similar numbers of oocytes and high-quality embryos in a shorter time for women with poor ovarian response.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-20 · read from full text ⓘ

This randomized controlled trial compared the dual stimulation (DuoStim) protocol against the conventional antagonist protocol in 90 women with poor ovarian response undergoing intracytoplasmic sperm injection. The study found that while DuoStim significantly reduced the total number of retrieved oocytes and shortened the duration of ovarian stimulation, it yielded comparable numbers of mature metaphase II oocytes and embryos to the conventional method. Participants excluded from the analysis included those with endometriosis higher than grade 3, indicating a specific exclusion criterion for severe disease. Relevance to endometriosis: endometriosis is explicitly listed as an exclusion criterion for participants with stage greater than 3, but the paper's main focus is on poor ovarian response protocols rather than the condition itself.

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Abstract

BackgroundIn 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.ObjectiveThe 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 methodsThis 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.ResultsThe mean number of metaphase II eggs was 5.7 ± 3.9 in the DuoStim group and 6.2 ± 3.9 in the conventional group (p = 0.53). The mean total number of retrieved eggs in the DuoStim group was 7.2 ± 4.5, and in the conventional group, it was 9.7 ± 6.04 (p = 0.026). The mean number of embryos obtained in the DuoStim group was 4.5 ± 3.9; in the conventional group, it was 4.7 ± 2.8 (p = 0.016).ConclusionIn 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.
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The authors would like to thank all the individuals who allowed us to use their medical records. We also would like to acknowledge our colleagues at the Arash Women's hospital, Tehran, Iran. We used Perplexity AI for checking grammar in some sections of this article.

Coi Statement

The authors declare that there is no conflict of interest.

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