Κατεύθυνση Έρευνα στην Γυναικεία ΑναπαραγωγήLibrary of the School of Health Sciences
Μαρία Σιμοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, Ε.Κ.Π.Α., Επιβλέπουσα
Γεώργιος Μαστοράκος, Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α
Μιχαήλ Κουτσιλιέρης, Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α
Διερεύνηση της ασφάλειας και της αποτελεσματικότητας της διπλής ωοθηκικής διέγερσης σε γυναίκες με ελαττωμένο ωοθηκικό απόθεμα. Συστηματική ανασκόπηση και μετα-ανάλυση.
Investigating the safety and efficacy of double ovarian stimulation (DuoStim) in poor responders. Systematic review and meta-analysis.
The present thesis has a primary focus on the investigation of the safety and efficacy of the dual ovarian stimulation protocol (DuoStim) and the following double ovulation within the same menstrual cycle for patients with reduced ovarian reserve (POR).
A systematic bibliography review was performed in the following databases: PubMed/Medline, Embase and Cochrane Central Library along with any publications that existed up to March 2019. All prospective and retrospective cohort studies that were found eligible for inclusion referred to women with reduced ovarian reserve (POR) which were subjected to dual stimulation (DuoStim) in the follicular (FPS) and luteal (LPS) phase in the same menstrual cycle. The review was followed by an appropriate meta-analytical approach.
A demonstration in regards to the association between double ovarian stimulation (DuoStim) and a higher number of retrieved oocytes, mature metaphase II cells and embryos of good quality compared to regular approaches is reflected in this thesis. Furthermore, the stimulation during the luteal phase (LPS) appears to have similar, and in some instances even higher overall performance when compared to stimulation during the follicular phase (FPS).
In conclusion, the dual stimulation protocol (DuoStim) favors an enhanced clinical outcome in relation to the total number of produced oocytes, mature oocytes and available embryos along with the quality of the embryos retrieved. Unprocessed raw data indicate that the luteal phase (LPS) is not associated with a higher rate of aneuploidy. Therefore, this option might actually be more favorable for managing patients with reduced ovarian reserve since their condition is highly dependent on the timing of the treatment as it allows for a higher yield of healthy oocytes during a menstrual cycle.
Main subject category:
Poor responders, Lupor, Duostim, LPS, IVF