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

Krutova V.A., Golovko A.K.

1) Kuban State Medical University Clinic, Ministry of Health of the Russian Federation, Krasnodar, Russia; 2) Kuban State Medical University, Ministry of Health of the Russian Federation, Krasnodar, Russia
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.

Keywords

in vitro fertilization
diminished ovarian reserve
luteal-phase stimulation
follicular-phase stimulation

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Received 22.07.2021

Accepted 22.11.2021

About the Authors

Viktoriya A. Krutova, Dr. Med. Sci., Professor of the Department of Obstetrics, Gynecology and Perinatology, Kuban State Medical University, Ministry of Healthcare of the Russian Federation; Chief Administrator of the Clinic of Kuban State Medical University, Ministry of Healthcare of the Russian Federation, +7(918)436-69-93,
vik-krutova@yandex.ru, https://orcid.org/0000-0002-9907-7491, 350072, Russia, Krasnodar, Zipovskaya str., 4/1.
Anfisa K. Golovko, Post-graduate student of the Department of Obstetrics, Gynecology and Perinatology, Kuban State Medical University, Ministry of Healthcare of the Russian Federation, +7(964)937-13-04, anfisa.golovko@mail.ru, 350072, Russia, Krasnodar, Zipovskaya str., 4/1.
Corresponding author: Anfisa K. Golovko, anfisa.golovko@mail.ru

Authors’ contributions: Krutova V.A. – concept development – idea formation; conduction of the investigation – analysis and interpretation of the findings; text preparation and editing – critical revision of a draft manuscript with the valuable comment on the intellectual content; development of the design of the investigation; approval of the final version – acceptance of responsibility for all aspects of the investigation, the integrity of all parts of the article and its final version; A.K. Golovko – concept development – formulation or development of key goals and objectives; conduction of the investigation – review of publications on the topic of the article; data collection; text preparation and editing - writing the text of the manuscript; abstract writing; preparation and writing the published work; approval of the final version - acceptance of responsibility for all aspects of the investigation, the integrity of all parts of the article and its final version.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The authors declare that there is no investigation sponsorship.
For citation:Krutova V.A., Golovko A.K. Ovarian stimulation in the lutein phase of the menstrual cycle and in the double stimulation mode in patients with lower diminished ovarian reserve values.
Akusherstvo i Ginekologiya/ Obstetrics and Gynecology. 2021; 12: 24-30 (in Russian)
https://dx.doi.org/10.18565/aig.2021.12.24-30

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