Comparison of the results of dual stimulation protocol and conventional antagonist protocol in poor responders in in vitro fertilization

INTRODUCTION AND OBJECTIVE: In this study, we were aimed to investigate the effectiveness of the LPS by comparing the FP and LP stimulations within the DuoStim protocol itself and with the DuoStim vs. ConStim comparison, demonstrate the effectiveness of the DuoStim protocol according to the ConStim protocol in the DOR patients. MATERIAL AND METHODS: In this retrospective case-control study, the patients who received treatment at SÜEAH ÜYTEM between January 2019 and February 2020 and that were expected as poor responder according to POSEIDON classification, were included. The total DuoStim results obtained from the FPS and LPS of the patients compared with ConStim protokols results and also compared in terms of the same data between the FP and LP cycles within the Duostim protocol. RESULTS: A total of 49 cases in the DuoStim group and 151 cases in the ConStim group were included in the study. In the DuoStim group, the number of dominant follicles on the trigger day, the number of MII oocytes, fertilized oocytes and D3 embryos per patient and their good quality rates, and the amount of drugs used were higher than the ConStim group (p<0.05). However, even the Blastocyst was found to be high in number, no statistical significance was found. In the LPS group, the number of MII oocytes, fertilized oocytes and blastocysts, and the utilization rate of the 2PN oocytes were higher than FPS. In the comparison made by POSEIDON groups, the number of MII oocytes was higher in all groups than FPS and in DuoStim compared to ConStim (p<0.05). In terms of the number of embryos available, POSEIDON groups 1 and 2 were found to be more successful than the ConStim protocol (p<0.05). CONCLUSION: In order to obtain more MII oocytes and usable embryos in a shorter time in DOR patients, the DuoStim protocol can be used by inorming the couples about cost-effectiveness. However, there is a need for more cost-effectivity analysis with the studies to be performed by comparing one DuoStim cycle with two ConStim cycles performed on the same patient at different times. Keywords: Dimished ovarian reserve, Dual Stimulation, Infertility, In-Vitro Fertilization, Luteal phase stimulation, POSEIDON Classification.