Routine double-ovarian-stimulation (DuoStim) in poor responders lacks rationale, evidence, and follow-up

Abstract

Double ovarian stimulation (DuoStim), initially only suggested for fertility preservation in cancer patients, is now increasingly also used in routine clinical IVF, especially in poor responders. The claimed rational for this is the alleged existence of multiple follicular waves in a single intermenstrual interval, allowing for retrieval of more oocytes in a single IVF cycle. This commentary argues that this expansion of purpose lacks rationale, evidence, and follow-up. Consequently, we suggest that, unless valid clinical indications have been established, DuoStim be only subject of controlled clinical trials with appropriate experimental consents.

Keywords: DuoStim; IVF-ET; double-ovarian-stimulation; evidence; follow-up; live birth rate; ovarian stimulation; poor ovarian response; rational.