DUOSTIM Protocol for Women Over 40
Ideal Stimulation Protocols for Women Over 40
An increasing number of women around the age of 40 are turning to IVF centers worldwide, either to conceive for the first time or to have another child in the same or a new relationship. The main challenge in this age group lies in the reduced ovarian reserve, resulting in a lower number of eggs available for fertilization. However, the truth is that the majority of retrieved eggs have a higher likelihood of leading to a successful pregnancy.
Thus, our goals are to retrieve more eggs and improve their quality. The chosen protocol, medications, and duration of stimulation will play a crucial role in achieving this. We now know that administering high doses of medication or increasing the dosage during stimulation does not yield better results. Additionally, a weekly injection can replace daily medication doses, which many women undergoing IVF find intimidating.
For women with low ovarian reserve, the stimulation period is shorter, as studies indicate that a shorter stimulation phase improves fertilization rates due to premature luteinization, which negatively impacts egg quality.
DUOSTIM Protocol: The Solution for Low Ovarian Reserve
The DUOSTIM protocol, or double stimulation—either within the same cycle (luteal phase) or in the immediately following cycle—offers an effective solution for women with low ovarian reserve. Research suggests that the second stimulation results in better-quality eggs, which, upon fertilization, develop into blastocysts (day 5 embryos), significantly increasing the chances of a successful pregnancy.
It’s All About the Lab
Before undergoing stimulation, taking specific fertility-enhancing vitamins for a short period—both for the woman and her partner—can improve fertilization outcomes. However, achieving success requires a high-quality laboratory capable of handling the limited number of retrieved eggs.
The greatest differences in IVF clinic success rates appear within this age group. Studies also show that artificial intelligence (AI) and preimplantation genetic testing (PGT) offer limited benefits in improving pregnancy outcomes when working with a small number of blastocysts, aside from increasing treatment costs.
We Love Eggs
Women now have the ability to pause their biological clock by freezing their eggs, ideally around age 35, for future use. This option was not available a few years ago due to the lack of suitable laboratory culture materials that could preserve eggs at optimal quality for fertilization.
Egg freezing allows women to try conceiving naturally first and, if needed, use their own eggs at a later age to achieve pregnancy. The safe and effective protocols mentioned above, along with a modern laboratory equipped with AI programs, can help determine the ideal number of eggs a woman should freeze to secure her reproductive future.
Stelios Papadopoulos, MD, DFFP, BSCCP
Obstetrician - Gynecologist - Reproductive Surgeon
Trained in the UK
INSTITUTE OF LIFE
email:
www.ivfclinic.gr
www.steliospapadopoulos.gr