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Duo Stimulation

At CARE, we believe that family is for everyone. We know that all our patients have individual needs, that’s why we focus on a personalised treatment plan, designed for you. There are many ways we can personalise treatment and Duo Stimulation is an approach that is suitable for some patients.

 

Usually in an IVF treatment cycle, medication is used to trigger a single round of ovary stimulation; this causes follicles to grow which are then collected, fertilised and the resulting embryos are either transferred or frozen depending on quality.

Patients are typically advised to wait for a menstrual cycle or two following ovarian stimulation before another cycle is started. 

 

What is Duo Stimulation?

Duo Stimulation is designed for patients who produce very low numbers of follicles or eggs when the maximum dose of stimulation drugs is used. In this instance, there would only be a small chance of improving the results of stimulation in subsequent cycles.

Research assessed the benefit of starting a second stimulation of the ovaries with the same high dose of drugs within 5 days of the first egg collection in an attempt to build on the work of the first dose of drugs to improve the number of eggs retrieved in a second egg collection procedure. 

In short, you would undergo a round of ovarian stimulation, any developed follicles will be drained, the collected eggs will be fertilised and any subsequent embryos, of suitable quality, frozen. You would start another round of ovarian stimulation by day 5 following your first egg collection and go through a second egg collection procedure 9-12 days later where collected eggs will be fertilised and subsequent embryos of suitable quality will be frozen. 

Due to the way the medication is administered, all embryos must be frozen rather than transferred fresh within the rapid sequence stimulation cycle. 

 

What are the benefits of Duo Stimulation?

Research suggests that there is an increase in the number of eggs retrieved and an improvement in the quality of embryos that develop in the second cycle of ovarian stimulation during a Duo Stimulation treatment cycle.

This method of stimulation means that two rounds of ovarian stimulation are completed over the course of 6 weeks as opposed to up to 12-16 weeks using conventional stimulation. 

 

Who is Duo Stimulation recommended for?

Dup Stimulation treatment is recommended for patients who have a low ovarian reserve as demonstrated by either:

  • A low level of Anti Mullerian Hormone (AMH)
  • A raised level of Follicle Stimulating Hormone (FSH)
  • A low level of small (antral) follicles in the ovaries on your scan (Antral Follicle Count)
  • A poor response to stimulation in a previous treatment cycle.

 

Is there a risk of producing poorer eggs with each cycle as the ovary doesn’t have time to recover?

We used to think that it was best to wait a couple of menstrual cycles after stimulation before attempting further treatment to allow the ovaries to recover, however, there is clear evidence that the drugs we give do not decrease the “reservoir” of early eggs.

Instead, even if only a few follicles are created from the first stimulation, the drugs in the first stimulation help recruit the next set of early follicles that can be stimulated straight away in the second cycle. If we wait, those small follicles that have been recruited will die after a few weeks. 

 

What happens if I don’t produce any follicles or eggs from my first cycle?

If your ovaries do not produce any follicles or eggs, your clinician will review the results of the scan and discuss the options of a second stimulation cycle. This will be based on the number of small follicles that have been created in this first stimulation, what we call the secondary cohort so that you can decide together whether it is appropriate to continue to a second cycle or not. Your clinic team are on hand support you through the process, ensuring you make the best decision for you.

 

If I don’t produce enough eggs then shouldn’t I have more medication next time?

Duo Stimulation uses the maximum recommended dose of drugs to stimulate your ovaries so there would not be an option to increase the medication on the next stimulation cycle. 

 

Is there anything else that can be offered with this treatment?

Because Duo Stimulation treatment involves the freezing of any embryos of suitable quality, some patients choose to have these embryos biopsied and genetically tested before they are frozen using PGT-A.

 

Where can I find more information on Duo Stimulation?

We recommend contacting your local CARE Fertility clinic to chat with your doctor about this treatment. You can also contact our enquiries team on 0800 564 2270 who would be happy to help you.

With love from CARE x

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