Double the chance of IVF success?

A Sydney-based IVF specialist has achieved a pregnancy in a patient through a double stimulation IVF cycle, the first of its kind in Australia.

Dr David Knight from Demeter Fertility, is pioneering a ground-breaking fertility treatment known as ‘double stimulation’ – the combination of two stimulations in one menstrual cycle.

According to Dr Knight, double stimulation provides enormous potential and hope for those undergoing fertility treatment, because it allows two chances for egg collection in a single menstrual cycle – effectively doubling the chance of pregnancy for those undergoing IVF.

The protocol potentially reduces the number of IVF cycles required to achieve a pregnancy for a patient, and therefore the overall physical, emotional and financial burden for patients undergoing fertility treatment.

How does it work?

The human menstrual cycle is caused and is regulated by the growing egg, which develops in structures in the ovary called follicles. Follicles undergo significant dynamic structural and hormonal changes during the cycle. The ovary contains about 1 to 2 million eggs at birth, around 400,000 eggs at puberty, yet after menstruation starts around 1,000 eggs each month either grow or die.

Of the thousand eggs that grow/die every month, only 5-50 at any one time will be in a state that allows them to respond to the body’s hormones. These eggs all begin to grow, and the egg that is the most competent is the only one released. ‘Most competent’ egg means that egg that is the best able to perform all the tasks required, compared with all the others around at that time.

“It’s at this point that we consider double stimulation,” says Dr Knight. “This is basically doing a standard IVF cycle treatment up to the point of egg collection, however we then begin stimulation again.

“The eggs collected are frozen for use later, and no embryos are transferred. The stimulation process is started again and commences through the next 1-2 weeks when a second egg collection is done.

The best egg has now been collected from ‘two cohorts’ in the same cycle, effectively doubling the chances of the patient getting pregnant.”

What are the advantages?

The advantage of double stimulation is not only that more eggs are collected, but more importantly, these mature eggs are collected from more than one cohort in a cycle. There is a reduced cancellation rate and a more flexible stimulation protocol. There are also different responses from the body and because the second stimulation is after ovulation there is no spontaneous hormone surge triggering the early release of eggs. And finally there is an almost absence of Ovarian Hyperstimulation Syndrome.

“Double stimulation is a promising approach for patients who are in the older reproductive age group (40-45yrs), known to only collect few eggs with an associated low pregnancy rates,” says Dr Knight.

“Also for patients who have been classified as ‘poor responders’, such as having repeated problems with no eggs able to be collected or viable embryos using conventional IVF protocols, or for cancer patients needing emergency fertility preservation.”

Double stimulation represents a significant new advance in IVF treatment for suitable patients. Dr Knight recommends that if you are having problems conceiving and are concerned you should visit your doctor to find out what options are best for you. It is important for any woman considering having a baby to receive tailored information that best suits their age and specific situation.

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