ABSTRACT
Objective To discuss the value of double stimulations and mild ovarian stimulation combined with Gn-RH-antagonist in patients with decreased ovarian reserve receiving in vitro fertilization and embryo transfer ( IVF-ET) . Methods 283 patients with decreased ovarian reserve who accepted in vitro fertilization were analyzed retro-spectively. 204 cases accepted double stimulations and 79 cases accepted mild ovarian stimulation combined with GnRH-antagonist, compared the outcomes of the two protocols. Results The average number of oocytes retrieved, viable embryos,high-quality embryos,consumption and duration of Gn,the serum progesterone( P) level on trigger day in the luteal phase were significantly higher than those in follicular phase. The serum luteinizing hormone( LH) level on trigger day was lower than that in follicular phase. The average number of oocytes retrieved,high-quality embryos,consumption and duration of gonadotropins( Gn) in mild stimulation combined with GnRH-antagonist were higher than those in follicular phase. LH level on trigger day was lower than those in follicular phase, while the numbers of viable embryos were similar. The consumption and duration of Gn in the luteal phase were higher than in stimulation combined with GnRH-antagonist, and there were no differences in the average number of oocytes re-trieved,viable embryos,high-quality embryos between the two groups. The cycle cancellation rate, available rate of oocytes and embryos were similar between the controlled ovarian hyperstimulation. The available rate of embryos in double stimulations was higher than mild ovarian stimulation combined with GnRH-antagonist,and the abortion rate was lower. Conclusion Controlled ovarian hyperstimulation during luteal phase can get better outcomes in patients with decreased ovarian reserve,double stimulations in the same menstrual cycle shortens the treatment time of IVF-ET,and it is a feasible method for patients with decreased ovarian reserve.