O-069 Double vs. single stimulation in young poor prognosis patients followed by a fresh embryo transfer: a randomized controlled trial.

Abstract Study question Does double stimulation, followed by a fresh ET (DUO-STIM fresh) improve outcomes as compared with single stimulation in young poor prognosis patients? Summary answer Compared to DUO-STIM leads significantly higher number of good quality embryos, without hindering embryo transfer outcomes. What is known already Dual Stimulation (ovarian both the follicular and luteal phase same cycle) an innovative strategy retrieve oocytes shorter time frame, thus it particularly appealing for ovarian responders. Three current limitations Dual-Stimulation are: (1) unclear whether second (luteal) wave results from or carry-over effect previous stimulation; (2) desynchronization between endometrium ovaries and, (3) lack robust evidence. No studies explored starting phase, (DUOSTIM-fresh). design, size, duration This study prospective, randomized, controlled, single-center, superiority clinical trial comparing two different protocols: cycle vs. ET. The primary outcome was embryos obtained, while secondary included (clinical pregnancy, miscarriage). A total 120 women were enrolled this October 2020 2022, 1:1allocation. Participants/materials, setting, methods Only (<40 years old) poor-prognosis (AMH<1.2 ng/mL) patients recruited Fertility Clinic within tertiary University Hospital. In investigational group, DUOSTIM-fresh, 1st initiated 2nd 5 days post first OPU, best generated (1st cycle). control group performed Main role chance Overall, 107 53 54 arm (single stim). resulted stim (difference mean 0.81, 95% CI 0.12-1.49). percentage comparable (62.3 51.9, respectively vs stimulation). significant differences found (ongoing pregnancy rates: 24.5 22.2, conventional IVF). Of interest comparisons cycles (A: B: DUOSTIM-fresh C: didn’t demonstrate any difference terms response (SD) mature being 3.3 (2.9) 3.4 (3.4) 3.5 (2.9), respectively). Limitations, reasons caution sample size calculated detect on good-quality embryos. Therefore, (embryo rates rates) should be interpreted exploratory findings that warrant future investigations. Wider implications Although blastocysts patients, decision performing dual evaluated considering may transfers rate still unclear. Results Cumulative-Live-Birth-Rate are warranted. Trial registration NCT04446845