Ovarian stimulation in the lutein phase of the menstrual cycle and in the double stimulation mode in patients with lower diminished ovarian reserve values


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Abstract

In vitro fertilization is still characterized by lower success rates in women who fail to respond adequately to controlled ovarian stimulation, also known as poor responders. To search for an effective treatment for this group of patients is an important problem. Objective: To provide up-to-date information on the use of protocols for ovarian function stimulation in the luteal phase of the menstrual cycle and in the double stimulation mode in patients with lower ovarian reserve values. Methods: Publications were sought for in the databases PubMed, eLibrary, Web of Science, Cochrane Library, and CyberLeninka. The search depth was 10 years. The systematic search used the following keywords: ovarian stimulation in the luteal phase, double stimulation, and diminished ovarian reserve; as well as double stimulations, luteal-phase ovarian stimulation, poor ovarian response, controlled ovarian stimulation, and second follicular wave in English-language publications. Results: The review included 42 of the 89 literature sources analyzed. This review of current studies has shown that ovarian stimulation can be safely and effectively initiated at any point in the menstrual cycle. Double ovarian stimulation is a promising protocol for patients, from whom the largest number of oocytes should be retrieved in the shortest possible time when one superovulation stimulation session is not enough or when the period for assisted reproductive technologies is limited. The literature data indicate that this strategy is a possible option to compensate for the inadequate ovarian response that sometimes occurs in assisted reproductive technology programs, especially in patients with lower ovarian reserve values. Conclusion: Ovarian function stimulation in the follicular and luteal phases of the menstrual cycle is a new strategy aimed at increasing the numbers of retrieved oocytes and obtained good-quality embryos. Just the same, there is a need for further investigation of the efficiency and safety of double stimulation in patients with diminished ovarian reserve

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About the authors

Viktoriya A. Krutova

Kuban State Medical University Clinic, Ministry of Health of the Russian Federation; Kuban State Medical University, Ministry of Health of the Russian Federation

Email: vik-krutova@yandex.ru
Dr. Med. Sci., Professor of the Department of Obstetrics, Gynecology and Perinatology; Chief Administrator

Anfisa K. Golovko

Kuban State Medical University, Ministry of Health of the Russian Federation

Email: anfisa.golovko@mail.ru
Post-graduate student of the Department of Obstetrics, Gynecology and Perinatology

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