title: Double stimulations during the follicular and luteal phases of poor responders in IVF/ICSI programmes (Shanghai protocol).
abstract: Previous studies have shown that existing antral follicles in the luteal phase enable ovarian stimulation. In a pilot study, the efficacy of double stimulations during the follicular and luteal phases in women with poor ovarian response was explored (defined according to the Bologna criteria). Thirty-eight women began with mild ovarian stimulation. After the first oocyte retrieval, human menopausal gonadotrophin and letrozole were administrated to stimulate follicle development, and oocyte retrieval was carried out a second time when dominant follicles had matured. The primary outcome measured was the number of oocytes retrieved: stage one 1.7 ± 1.0; stage two 3.5 ± 3.2. From the double stimulation, 167 oocytes were collected and 26 out of 38 (68.4%) succeeded in producing one to six viable embryos cryopreserved for later transfer. Twenty-one women underwent 23 cryopreserved embryo transfers, resulting in 13 clinical pregnancies. The study shows that double ovarian stimulations in the same menstrual cycle provide more opportunities for retrieving oocytes in poor responders. The stimulation can start in the luteal phase resulting in retrieval of more oocytes in a short period of time. This offers new hope for women with poor ovarian response and newly diagnosed cancer patients needing fertility preservation.
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address: Kuangyanp@126.com.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Kuang
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Qiuju
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Hong
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Qifeng
authors.initials: Q
authors.lastname: Lyu
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Ai
authors.initials: A
authors.lastname: Ai
authors.affiliation: Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yonglun
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Zeev
authors.initials: Z
authors.lastname: Shoham
mesh_terms: D015925:Cryopreservation / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005498:Follicular Phase / Q000502:physiology*; D006801:Humans; D008183:Luteal Phase / Q000502:physiology*; D009865:Oocytes / Q000166:cytology / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
keywords: double stimulations; luteal-phase ovarian stimulation; mild stimulation; poor ovarian response