I recently had the opportunity to speak at a fertility congress in São Paulo, Brazil, where I addressed a topic that often sparks debate: Is it worthwhile to use the DuoStim protocol?

DuoStim, or double ovarian stimulation within the same menstrual cycle, involves performing stimulation during the follicular phase (after menstruation) and, following ovarian puncture and oocyte retrieval, initiating a second stimulation in the luteal phase of the same cycle. The goal is to obtain more oocytes in less time, avoiding the wait for the next menstrual cycle for a new stimulation.

In Which Cases Is It Clearly Indicated?

There are situations where DuoStim can be particularly beneficial:

• Fertility preservation in oncology patients: when time is critical before starting treatments like chemotherapy or radiotherapy.

• Patients with time constraints: such as those traveling from abroad for fertility treatments and wishing to minimize the number of trips.

And in Other Cases?

For patients with low ovarian reserve or advanced maternal age, it has been suggested that DuoStim could reduce treatment dropout rates by offering two consecutive opportunities for oocyte retrieval. However, scientific evidence on this is limited, and some studies have observed selection bias that could influence the results.

Additionally, while some studies indicate that DuoStim may reduce the time to obtain a euploid embryo by approximately 20 days, this benefit may not be clinically significant for all patients.

Conclusion

DuoStim is a valuable tool in specific contexts where time is a critical factor. However, its application should be based on individualized assessment and the best available scientific evidence. It’s essential for patients to feel comfortable discussing their options and, if desired, seeking a second opinion.

If you’d like to delve deeper into this topic, you can consult our publication in Fertility and Sterility (2024) in the debates section.