double ovarian stimulation versus using antagonist with a high dose of gonadotropin in women with poor ovarian response: a randomized clinical trial study

Background: poor ovarian response (por) to ovarian stimulation is a challenging factor in assisted reproduction technology (art). this study aimed to compare the efficacy of a conventional antagonist with high doses of gonadotropin protocol with double stimulation protocol in females with por.methods: this randomized clinical trial study was conducted on 60 women aged >35 with pors at the avicenna infertility center, tehran, iran. the participants were randomly divided into 2 groups (n=30 /each). in group 1, from the second day of the menstrual cycle, gonadotropin started at a dose of 450-600 units. in group 2, the second day of the menstrual period began with letrozole 5 mg every night and an oral tablet of clomiphene citrate 50 mg every day, and from the fourth day started 150 units of gonadotrophin (triptorelin, 0.2 mg). results: in this study, at the end of the follicular phase, there was a significant correlation between protocol type and the number of germinal vesicles (gv) (p=0.04). the mean number of oocytes retrieved was 2.76±1.9 in the conventional method and 3.23±2.1 in the double stimulation group (p=0.90). the number of fertilized oocytes was 31 in the conventional protocol and 25 in the double stimulation protocol. the mean number of pregnancies that led to the fetus was 1.38±1.3 in the conventional protocol and 0.96±0.9 in the double stimulation group (p=0.018).conclusion: the results of this study show that the embryos in the double-stimulation group were more capable of completing the pregnancy, and the double-stimulation group had a higher live birth rate.