Dual Stimulation in In Vitro Fertilization

In vitro fertilization, IVF is a set of procedures that includes combining eggs of a female and sperm of a male outside the mother’s womb. Once the embryos are formed they are placed inside the uterus.
Ovarian stimulation is done during IVF in order to retrieve multiple mature eggs from the female ovaries. Multiple eggs maximize the chances of increased number of fertilized eggs that can be implanted back in the uterus, thus increasing the chances of pregnancy leading to a healthy baby.
Ovarian stimulation in IVF involves injection of medication consisting mainly hormones for 8-14 days starting from the second day of periods. These injections cause the ovaries to stimulate and mature multiple eggs. Frequent ultrasounds are done to monitor the increasing sizes of the follicles encircling the eggs. Once the follicles have reached a favorable size, egg retrieval is done. These eggs are then injected with the male sperm and eventually fertilization occurs.

Dual Stimulation or double stimulation is done in patients who show a poor response to hormonal injections usually due to a poor ovarian reserve. Poor response usually corresponds to retrieval of fewer mature eggs.
As the name suggests, dual stimulation has 2 rounds of stimulation done in order to retrieve as many mature eggs as possible. The 1st stimulation starts from 2nd day of periods till the 1st retrieval and second stimulation begins from the next day. This stimulation is also done with injections that again stimulate the ovaries to mature a few more eggs. When the ultrasound shows an increase in the follicle size, a second egg retrieval is done. These 2 stimulation and retrievals yield a good number of eggs that can be fertilized leading to a greater chance of a successful pregnancy after implantation.

 

By -Dr. Sundus Saeed Gill

ACIMC Lahore, Coordinator (MBBS)


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