International Journal of Infertility & Fetal Medicine

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VOLUME 11 , ISSUE 2 ( May-August, 2020 ) > List of Articles


Luteal Start of Stimulation in a Case of Expected Poor Response with the Successful Outcome: A Case Report

Shruti Gupta

Citation Information : Gupta S. Luteal Start of Stimulation in a Case of Expected Poor Response with the Successful Outcome: A Case Report. Int J Infertil Fetal Med 2020; 11 (2):54-56.

DOI: 10.5005/jp-journals-10016-1206

License: CC BY-NC 4.0

Published Online: 01-05-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Purpose: Poor responder is a quasi-cluster of patients whose management has confounded clinicians. Luteal phase stimulation as a solution is proposed on a new principle of follicular development. Case description: Mrs. X, a 34-year-old woman with an anti-Mullerian hormone (AMH) of 0.86 ng/mL and a history of failed in vitro fertilization (IVF) with the recovery of one egg was stimulated in the luteal phase. The patient's ovarian stimulation was done with menopur 375 IU, cetrotide 0.25 mg was added after 8 days. The stimulation lasted for 15 days. Results: There were seven oocytes recovered, two blastocysts were formed and transferred in a freeze–thaw cycle. This resulted in a live-born preterm fetus at 27 weeks in view of bleeding placenta previa. Conclusion: Luteal phase stimulation can be another reasonable solution in the long list of stimulation regimens for patients who are poor responders.

  1. Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod 2011. 1–14.
  2. Wang N, Wang Y, Chen Q, et al. Luteal-phase ovarian stimulation vs conventional ovarian stimulation in patients with normal ovarian reserve treated for IVF: A large retrospective cohort study. Clin Endocrinol (Oxf) 2016;84(5):720. DOI: 10.1111/cen.12983.
  3. Kuang Y, Chen Q, Hong Q, et al. Double stimulations during the follicular and luteal phases of poor responders in IVF/ICSI programmes (Shanghai protocol). Reproduct Bio Med Online 2014;29(6):684–691. DOI: 10.1016/j.rbmo.2014.08.009.
  4. Mikolajczyk RT, Frank-Herrmann P, Freundl G, et al. More than one fertile ovulation per cycle? Fertil Steril 2004;81(3):728–729. DOI: 10.1016/j.fertnstert.2003.11.016.
  5. Baerwald AR, Adams GP, Pierson RA. Characterization of ovarian follicular wave dynamics in women. Biol Reprod 2003;69(3):1023–1031. DOI: 10.1095/biolreprod.103.017772.
  6. Moffat R, Pirtea P, Gayet V, et al. Dual ovarian stimulation is a new viable option for enhancing the oocyte yield when the time for assisted reproductive technnology is limited. Reprod Biomed Online 2014;29(6):659–661. DOI: 10.1016/j.rbmo.2014.08.010.
  7. Kansal Kalra S, Ratcliffe S, Gracia CR, et al. Randomized controlled pilot trial of luteal phase recombinant FSH stimulation in poor responders. Reprod Biomed Online 2008;17(6):745–750. DOI: 10.1016/S1472-6483(10)60400-2.
  8. Qin N, Chen Q, Hong Q, et al. Flexibility in starting ovarian stimulation at different phases of the menstrual cycle for treatment of infertile women with the use of in vitro fertilization or intracytoplasmic sperm injection. Fertil Steril 2016;106(2):334–341. DOI: 10.1016/j.fertnstert.2016.04.006.
  9. Ubaldi F, Capalbo A, Vaiarelli A, et al. Follicular versus luteal phase ovarian stimulation during the same menstrual cycle (DuoStim) in a reduced ovarian reserve population results in a similar euploid blastocyst formation rate: New insight in ovarian reserve exploitation. Fertil Steril 2016;105(6):1488–1495. DOI: 10.1016/j.fertnstert.2016.03.002.
  10. Cakmak H, Katz A, Cedars MI, et al. Effective method for emergency fertility preservation: random-start controlled ovarian stimulation. Fertil Steril 2013;100(6):1673–1680. DOI: 10.1016/j.fertnstert.2013.07.1992.
  11. Sfakianoudis K, Simopoulou M, Maziotis E, et al. Evaluation of the second follicular wave phenomenon in natural cycle assisted reproduction: a key option for poor responders through luteal phase oocyte retrieval. Medicina (Kaunas) 2019;55(3):68. DOI: 10.3390/medicina55030068.
  12. Zhu X, Ye H, Fu Y. Use of Utrogestan during controlled ovarian hyperstimulation in normally ovulating women undergoing in vitro fertilization or intracytoplasmic sperm injection treatments in combination with a “freeze all” strategy: a randomized controlled dose-finding study of 100 mg versus 200 mg. Fertil Steril 2017;107(2):379–386. DOI: 10.1016/j.fertnstert.2016. 10.030.
  13. Kuang Y, Hong Q, Chen Q, et al. Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles. Fertil Steril 2014;101(1):105–111. DOI: 10.1016/j.fertnstert.2013.09.007.
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