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Oocyte Retrieval in Double Stimulation

  • Qiuju Chen
  • Yanping Kuang
Chapter

Abstract

Follicle growth from the resting primordial stage until the pre-ovulatory phase takes several months; only the last 2 weeks of this long trajectory are dependent on gonadotropin support (Fig. 11.1) [1]. If maturing antral follicles achieve a distinct stage of development, they are programmed to die, but if serum FSH levels surpass a threshold, these follicles are rescued from atresia, i.e., gain gonadotropin dependence and continue their development [2]. Under normal conditions, elevated FSH levels above the threshold occur during the luteo-follicular transition. The subsequently follicular estradiol secretion inhibits pituitary secretion of FSH, which in turn causes the FSH concentration in the developing cohort follicles to drop below the threshold, the decreased FSH concentrations during the follicular phase are crucial for single dominant follicle selection (Fig. 11.2) [2]. The number of follicles recruited can be increased if endogenous FSH levels are augmented by exogenous gonadotropins or can be reduced if FSH levels are sufficiently diminished [3].

Keywords

Freeze-all Progesterone Controlled ovarian stimulation Double ovarian stimulation Luteal-phase ovarian stimulation Progestin-primed ovarian stimulation 

References

  1. 1.
    McGee EA, Hsueh AJ. Initial and cyclic recruitment of ovarian follicles. Endocr Rev. 2000;21:200–14.PubMedGoogle Scholar
  2. 2.
    Fauser BC, Van Heusden AM. Manipulation of human ovarian function: physiological concepts and clinical consequences. Endocr Rev. 1997;18:71–106.PubMedGoogle Scholar
  3. 3.
    diZerega GS, Hodgen GD. Folliculogenesis in the primate ovarian cycle. Endocr Rev. 1981;2:27–49.PubMedCrossRefGoogle Scholar
  4. 4.
    de Ziegler D, Fraisse T, de Candolle G, Vulliemoz N, Bellavia M, Colamaria S. Outlook: roles of FSH and LH during the follicular phase: insight into natural cycle IVF. Reprod Biomed Online. 2007;15:507–13.PubMedCrossRefGoogle Scholar
  5. 5.
    Chappel SC, Howles C. Reevaluation of the roles of luteinizing hormone and follicle-stimulating hormone in the ovulatory process. Hum Reprod. 1991;6:1206–12.PubMedCrossRefGoogle Scholar
  6. 6.
    Palermo R. Differential actions of FSH and LH during folliculogenesis. Reprod Biomed Online. 2007;15:326–37.PubMedCrossRefGoogle Scholar
  7. 7.
    Plant T, Zeleznik AJ. Knobil and Neil’s physiology of reproduction, vol. 1. 4th ed. Cambridge: Academic Press; 2014.Google Scholar
  8. 8.
    diZereg GS, Hodgen GD. Cessation of folliculogenesis during the primate luteal phase. J Clin Endocrinol Metab. 1980;51:158–60.CrossRefGoogle Scholar
  9. 9.
    Dierschke DJ, Yamaji T, Karsch FJ, Weick RF, Weiss G, Knobil E. Blockade by progesterone of estrogen-induced LH and FSH release in the rhesus monkey. Endocrinology. 1973;92:1496–501.PubMedCrossRefGoogle Scholar
  10. 10.
    Pohl CR, Knobil E. The role of the central nervous system in the control of ovarian function in higher primates. Annu Rev Physiol. 1982;44:583–93.PubMedCrossRefGoogle Scholar
  11. 11.
    March CM, Goebelsmann U, Nakamura RM, Mishell DR Jr. Roles of estradiol and progesterone in eiliciting the midcycle luteinizing hormone and follicle-stimulating hormone surges. J Clin Endocrinol Metab. 1979;49:507–13.PubMedCrossRefGoogle Scholar
  12. 12.
    Gougeon A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev. 1996;17:121–55.PubMedCrossRefGoogle Scholar
  13. 13.
    Richter TA, Robinson JE, Evans NP. Progesterone treatment that either blocks or augments the estradiol-induced gonadotropin-releasing hormone surge is associated with different patterns of hypothalamic neural activation. Neuroendocrinology. 2001;73:378–86.PubMedCrossRefGoogle Scholar
  14. 14.
    Richter TA, Robinson JE, Lozano JM, Evans NP. Progesterone can block the preovulatory gonadotropin-releasing hormone/luteinising hormone surge in the ewe by a direct inhibitory action on oestradiol-responsive cells within the hypothalamus. J Neuroendocrinol. 2005;17(3):161–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Attardi B, Scott R, Pfaff D, Fink G. Facilitation or inhibition of the oestradiol-induced gonadotrophin surge in the immature female rat by progesterone: effects on pituitary responsiveness to gonadotrophin-releasing hormone (GnRH), GnRH self-priming and pituitary mRNAs for the progesterone receptor A and B isoforms. J Neuroendocrinol. 2007;19:988–1000.PubMedCrossRefGoogle Scholar
  16. 16.
    Lasley BL, Wang CF, Yen SS. The effects of estrogen and progesterone on the functional capacity of the gonadotrophs. J Clin Endocrinol Metab. 1975;41:820–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Leyendecker G, Wildt L, Gips H, Nocke W, Plotz EJ. Experimental studies on the positive feedback effect of progesterone, 17 alpha-hydroxyprogesterone and 20 alpha-dihydroprogesterone on the pituitary release of LH and FSH in the human female. The estrogen priming of the progesterone feedback on pituitary gonadotropins in the eugonadal woman. Arch Gynakol. 1976;221:29–45.PubMedCrossRefGoogle Scholar
  18. 18.
    Helmond FA, Simons PA, Hein PR. The effects of progesterone on estrogen-induced luteinizing hormone and follicle-stimulating hormone release in the female rhesus monkey. Endocrinology. 1980;107:478–85.PubMedCrossRefGoogle Scholar
  19. 19.
    Knobil E. Regulation, by feedback, of gonadotropin hormone secretion in rhesus monkeys. Probl Actuels Endocrinol Nutr. 1974;18:37–8.PubMedGoogle Scholar
  20. 20.
    Wildt L, Hutchison JS, Marshall G, Pohl CR, Knobil E. On the site of action of progesterone in the blockade of the estradiol-induced gonadotropin discharge in the rhesus monkey. Endocrinology. 1981;109:1293–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Johnson MH. Essential reproduction. 6th ed. Blackwell Publishing; 2007. Chapter 5.Google Scholar
  22. 22.
    McNatty KP, Hillier SG, van den Boogaard AM, Trimbos-Kemper TC, Reichert LE Jr, van Hall EV. Follicular development during the luteal phase of the human menstrual cycle. J Clin Endocrinol Metab. 1983;56:1022–31.PubMedCrossRefGoogle Scholar
  23. 23.
    Pache T, Wladimiroff J, Dejong F, Hop W, Fauser B. Growth patterns of nondominant ovarian follicles during the normal menstrual cycle. Fertil Steril. 1990;54:638–42.PubMedCrossRefGoogle Scholar
  24. 24.
    Van Disseldorp J, Lambalk CB, Kwee J, Looman CW, Eijkemans MJ, Fauser BC, Broekmans FJ. Comparison of inter- and intra-cycle variability of anti-Mullerian hormone and antral follicle counts. Hum Reprod. 2010;25:221–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Rao GD, Chian RC, Son WS, Gilbert L, Tan SL. Fertility preservation in women undergoing cancer treatment. Lancet. 2004;363:1829–30.PubMedCrossRefGoogle Scholar
  26. 26.
    Chian RC, Buckett WM, Tan SL. In vitro maturation of human oocytes. Reprod Biomed Online. 2004;8:148–66.PubMedCrossRefGoogle Scholar
  27. 27.
    Grynberg M. The challenge of fertility preservation in cancer patients: a special focus issue from future oncology. Future Oncol. 2016;12:1667–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Chian RC, Chung JT, Downey BR, Tan SL. Maturational and developmental competence of immature oocytes retrieved from bovine ovaries at different phases of folliculogenesis. Reprod Biomed Online. 2002;4:127–32.PubMedCrossRefGoogle Scholar
  29. 29.
    Chian RC, Huang JY, Gilbert L, Son WY, Holzer H, Cui SJ, Buckett WM, Tulandi T, Tan SL. Obstetric outcomes following vitrification of in vitro and in vivo matured oocytes. Fertil Steril. 2009;91:2391–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Baerwald A, Adams G, Pierson R. Characteristics of ovarian follicular wave dynamics in women. Biol Reprod. 2003;69:1023–31.PubMedCrossRefGoogle Scholar
  31. 31.
    Baerwald AR, Adams GP, Pierson RA. Ovarian antral folliculogenesis during the human menstrual cycle: a review. Hum Reprod Update. 2012;18:73–91.PubMedCrossRefGoogle Scholar
  32. 32.
    Baerwald A, Adams G, Pierson R. A new model for ovarian follicular development during the human menstrual cycle. Fertil Steril. 2003;80:116–22.PubMedCrossRefGoogle Scholar
  33. 33.
    Bianchi PH, Viera LM, Gouveia GR, Rocha AM, Baruselli PS, Baracat EC, Serafini PC. Study of two strategies to induce follicular wave emergence for assisted reproductive treatments (ART)—a preliminary trial. J Assist Reprod Genet. 2015;32:543–9.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Baerwald AR, Adams GP, Pierson RA. Form and function of the corpus luteum during the human menstrual cycle. Ultrasound Obstet Gynecol. 2005;25:498–507.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Adamsa GP, Jaiswalb R, Singha P, Malhic J. Progress in understanding ovarian follicular dynamics in cattle. Theriogenology. 2008;69(1):72–80.CrossRefGoogle Scholar
  36. 36.
    Viana JH, Dorea MD, Siqueira LG, Arashiro EK, Camargo LS, Fernandes CA, Palhão MP. Occurrence and characteristics of residual follicles formed after transvaginal ultrasound-guided follicle aspiration in cattle. Theriogenology. 2013;79:267–73.PubMedCrossRefGoogle Scholar
  37. 37.
    de Mello Bianchi PH, Serafini P, Monteiro da Rocha A, Assad Hassun P, Alves da Motta EL, Sampaio Baruselli P, Chada Baracat E. Review: follicular waves in the human ovary: a new physiological paradigm for novel ovarian stimulation protocols. Reprod Sci. 2010;17:1067–76.PubMedCrossRefGoogle Scholar
  38. 38.
    Edgar DH, Gook DA. A critical appraisal of cryopreservation (slow cooling versus vitrification) of human oocytes and embryos. Hum Reprod Update. 2012;18:536–54.PubMedCrossRefGoogle Scholar
  39. 39.
    Massin N. New stimulation regimens: endogenous and exogenous progesterone use to block the LH surge during ovarian stimulation for IVF. Hum Reprod Update. 2017;23:211–20.PubMedGoogle Scholar
  40. 40.
    Macklon NS, Stouffer RL, Giudice LC, Fauser BC. The science behind 25 years of ovarian stimulation for in vitro fertilization. Endocr Rev. 2006;27:170–207.PubMedCrossRefGoogle Scholar
  41. 41.
    Fauser BC, Devroey P, Yen SS, Gosden R, Crowley WF Jr, Baird DT, Bouchard P. Minimal ovarian stimulation for IVF: appraisal of potential benefits and drawbacks. Hum Reprod. 1999;14:2681–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Maman E, Meirow D, Brengauz M, Raanani H, Dor J, Hourvitz A. Luteal phase oocyte retrieval and in vitro maturation is an optional procedure for urgent fertility preservation. Fertil Steril. 2011;95:64–7.PubMedCrossRefGoogle Scholar
  43. 43.
    Decanter C, Robin G. Fertility preservation strategies in young women in case of breast cancer or hematologic malignancy. Gynecol Obstet Fertil. 2013;41:597–600.PubMedCrossRefGoogle Scholar
  44. 44.
    Kuang Y, Hong Q, Chen Q, Lyu Q, Ai A, Fu Y, Shoham Z. Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles. Fertil Steril. 2014;101:105–11.PubMedCrossRefGoogle Scholar
  45. 45.
    Zhang J. Luteal phase ovarian stimulation following oocyte retrieval: is it helpful for poor responders? Reprod Biol Endocrinol. 2015;13:76.PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Li Y, Yang W, Chen X, Li L, Zhang Q, Yang D. Comparison between follicular stimulation and luteal stimulation protocols with clomiphene and HMG in women with poor ovarian response. Gynecol Endocrinol. 2016;32:74–7.PubMedCrossRefGoogle Scholar
  47. 47.
    Kuang Y, Chen QJ, Hong QQ, Lyu QF, Fu YL, Ai A, Shoham Z. Luteal-phase ovarian stimulation case report: three-year follow- up of a twin birth. J IVF Reprod Med Genet. 2013;1:106.CrossRefGoogle Scholar
  48. 48.
    Kuang Y, Chen Q, Hong Q, Lyu Q, Ai A, Fu Y, Shoham Z. Double stimulations during the follicular and luteal phases of poor responders in IVF/ICSI programmes (Shanghai protocol). Reprod Biomed Online. 2014;29:684–91.CrossRefPubMedGoogle Scholar
  49. 49.
    Buendgen NK, Schultze-Mosgau A, Cordes T, Diedrich K, Griesinger G. Initiation of ovarian stimulation independent of the menstrual cycle: a case-control study. Arch Gynecol Obstet. 2013;288:901–4.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Wang N, Wang Y, Chen Q, Dong J, Tian H, Fu Y, Ai A, Lyu Q, Kuang Y. Luteal-phase ovarian stimulation vs conventional ovarian stimulation in patients with normal ovarian reserve treated for IVF: a large retrospective cohort study. Clin Endocrinol. 2016;84:720–8.CrossRefGoogle Scholar
  51. 51.
    Chen H, Wang Y, Lyu Q, Ai A, Fu Y, Tian H, Cai R, Hong Q, Chen Q, Shoham Z, Kuang Y. Comparison of live-birth defects after luteal-phase ovarian stimulation vs. conventional ovarian stimulation for in vitro fertilization and vitrified embryo transfer cycles. Fertil Steril. 2015;103:1194–201.PubMedCrossRefGoogle Scholar
  52. 52.
    Kuang Y, Chen Q, Fu Y, Wang Y, Hong Q, Lyu Q, Ai A, Shoham Z. Medroxyprogesterone acetate is an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization. Fertil Steril. 2015;104:62–70.PubMedCrossRefGoogle Scholar
  53. 53.
    Dong J, Wang Y, Chai WR, Hong QQ, Wang NL, Sun LH, Long H, Wang L, Tian H, Lyu QF, Lu XF, Chen QJ, Kuang YP. The pregnancy outcome of progestin-primed ovarian stimulation using 4 versus 10 mg of medroxyprogesterone acetate per day in infertile women undergoing in vitro fertilisation: a randomised controlled trial. BJOG. 2017;124:1048–55.PubMedCrossRefGoogle Scholar
  54. 54.
    Chen Q, Wang Y, Sun L, Zhang S, Chai W, Hong Q, Long H, Wang L, Lyu Q, Kuang Y. Controlled ovulation of the dominant follicle using progestin in minimal stimulation in poor responders. Reprod Biol Endocrinol. 2017;15:71.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Zhu X, Ye H, Fu Y. Use of utrogestan during controlled ovarian hyperstimulation in normally ovulating women undergoing in vitro fertilization or intracytoplasmic sperm injection treatments in combination with a “freeze all” strategy: a randomized controlled dose-finding study of 100 mg versus 200 mg. Fertil Steril. 2017;107:379–86.PubMedCrossRefGoogle Scholar
  56. 56.
    Zhu X, Ye H, Fu Y. Duphaston and human menopausal gonadotropin protocol in normally ovulatory women undergoing controlled ovarian hyperstimulation during in vitro fertilization/intracytoplasmic sperm injection treatments in combination with embryo cryopreservation. Fertil Steril. 2017;108:505–12.PubMedCrossRefGoogle Scholar
  57. 57.
    Yu S, Long H, Chang HY, Liu Y, Gao H, Zhu J, Quan X, Lyu Q, Kuang Y, Ai A. New application of dydrogesterone as a part of a progestin-primed ovarian stimulation protocol for IVF: a randomized controlled trial including 516 first IVF/ICSI cycles. Hum Reprod. 2018;33:229–37.PubMedCrossRefGoogle Scholar
  58. 58.
    Zhang J, Mao X, Wang Y, Chen Q, Lu X, Hong Q, Kuang Y. Neonatal outcomes and congenital malformations in children born after human menopausal gonadotropin and medroxyprogesterone acetate treatment cycles. Arch Gynecol Obstet. 2017;296:1207–17.PubMedCrossRefGoogle Scholar
  59. 59.
    Erb K, Klipping C, Duijkers I, Pechstein B, Schueler A, Hermann R. Pharmacodynamic effects and plasma pharmacokinetics of single doses of cetrorelix acetate in healthy premenopausal women. Fertil Steril. 2001;75:316–23.PubMedCrossRefGoogle Scholar
  60. 60.
    Sitruk-Ware R. New progestogens for contraceptive use. Hum Reprod Update. 2006;12:169–78.PubMedCrossRefGoogle Scholar
  61. 61.
    D’Arpe S, Di Feliciantonio M, Candelieri M, Franceschetti S, Piccioni MG, Bastianelli C. Ovarian function during hormonal contraception assessed by endocrine and sonographic markers: a systematic review. Reprod Biomed Online. 2016;33:436–48.PubMedCrossRefGoogle Scholar
  62. 62.
    Lu X, Hong Q, Sun L, Chen QJ, Fu Y, Ai A, Lyu Q, Kuang Y. Dual trigger for final oocyte maturation improves the oocyte retrieval rate of suboptimal responders to gonadotropin-releasing hormone agonist. Fertil Steril. 2016;106:1356–62.PubMedCrossRefGoogle Scholar
  63. 63.
    Kummer NE, Feinn RS, Griffin DW, Nulsen JC, Benadiva CA, Engmann LL. Predicting successful induction of oocyte maturation after gonadotropin-releasing hormone agonist (GnRHa) trigger. Hum Reprod. 2013;28:152–9.PubMedCrossRefGoogle Scholar
  64. 64.
    Youssef MA, Van der Veen F, Al-Inany HG, Mochtar MH, Griesinger G, Nagi Mohesen M, et al. Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist assisted reproductive technology. Cochrane Database Syst Rev. 2014;(10):CD008046.Google Scholar
  65. 65.
    von Wolff M, Thaler CJ, Frambach T, Zeeb C, Lawrenz B, Popovici RM, et al. Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil Steril. 2009;92:1360–5.CrossRefGoogle Scholar
  66. 66.
    Sönmezer M, Türkçüoğlu I, Coşkun U, Oktay K. Random-start controlled ovarian hyperstimulation for emergency fertility preservation in letrozole cycles. Fertil Steril. 2011;95:2125.PubMedCrossRefGoogle Scholar
  67. 67.
    Ozkaya E, San Roman G, Oktay K. Luteal phase GnRHa trigger in random start fertility preservation cycles. J Assist Reprod Genet. 2012;29:503–5.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Ethics Committee of American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. Fertil Steril. 2013;100:1224–31.CrossRefGoogle Scholar
  69. 69.
    Vaiarelli A, Venturella R, Vizziello D, Bulletti F, Ubaldi FM. Dual ovarian stimulation and random start in assisted reproductive technologies: from ovarian biology to clinical application. Curr Opin Obstet Gynecol. 2017;29(3):153–9.PubMedCrossRefGoogle Scholar
  70. 70.
    Danis RB, Pereira N, Elias RT. Random start ovarian stimulation for oocyte or embryo cryopreservation in women desiring fertility preservation prior to gonadotoxic cancer therapy. Curr Pharm Biotechnol. 2017;18:609–13.PubMedCrossRefGoogle Scholar
  71. 71.
    Cakmak H, Rosen MP. Ovarian stimulation in cancer patients. Fertil Steril. 2013;99:1476–84.PubMedCrossRefGoogle Scholar
  72. 72.
    Pereira N, Voskuilen-Gonzalez A, Hancock K, Lekovich JP, Schattman GL, Rosenwaks Z. Random-start ovarian stimulation in women desiring elective cryopreservation of oocytes. Reprod Biomed Online. 2017;35:400–6.PubMedCrossRefGoogle Scholar
  73. 73.
    Nayak SR, Wakim AN. Random-start gonadotropin-releasing hormone (GnRH) antagonist-treated cycles with GnRH agonist trigger for fertility preservation. Fertil Steril. 2011;96:e51–4.PubMedCrossRefGoogle Scholar
  74. 74.
    Qin N, Chen Q, Hong Q, Cai R, Gao H, Wang Y, Sun L, Zhang S, Guo H, Fu Y, et al. Flexibility in starting ovarian stimulation at different phases of the menstrual cycle for treatment of infertile women with the use of in vitro fertilization or intracytoplasmic sperm injection. Fertil Steril. 2016;106:334–41.PubMedCrossRefGoogle Scholar
  75. 75.
    Martínez F, Clua E, Devesa M, Rodríguez I, Arroyo G, González C, Solé M, Tur R, Coroleu B, Barri PN. Comparison of starting ovarian stimulation on day 2 versus day 15 of the menstrual cycle in the same oocyte donor and pregnancy rates among the corresponding recipients of vitrified oocytes. Fertil Steril. 2014;102:1307–11.PubMedCrossRefGoogle Scholar
  76. 76.
    Cardoso MCA, Evangelista A, Sartório C, Vaz G, Werneck CLV, Guimarães FM, Sá PG, Erthal MC. Can ovarian double-stimulation in the same menstrual cycle improve IVF outcomes? JBRA Assist Reprod. 2017;21:217–21.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Smitz J, Van Den AE, Bollen N, Camus M, Devroey P, Tournaye H, Van Steirteghem AC. The effect of gonadotrophin-releasing hormone (GnRH) agonist in the follicular phase on in-vitro fertilization outcome in normo-ovulatory women. Hum Reprod. 1992;7:1098–102.PubMedCrossRefGoogle Scholar
  78. 78.
    Liu C, Jiang H, Zhang W, Yin H. Double ovarian stimulation during the follicular and luteal phase in women ≥38 years: a retrospective case-control study. Reprod Biomed Online. 2017;35:678–84.PubMedCrossRefGoogle Scholar
  79. 79.
    Moffat R, Pirtea P, Gayet V, Wolf JP, Chapron C, de Ziegler D. Dual ovarian stimulation is a new viable option for enhancing the oocyte yield when the time for assisted reproductive technology is limited. Reprod Biomed Online. 2014;29:659–61.PubMedCrossRefGoogle Scholar
  80. 80.
    Ubaldi FM, Capalbo A, Vaiarelli A, Cimadomo D, Colamaria S, Alviggi C, Trabucco E, Venturella R, Vajta G, Rienzi L. Follicular versus luteal phase ovarian stimulation during the same menstrual cycle (DuoStim) in a reduced ovarian reserve population results in a similar euploid blastocyst formation rate: new insight in ovarian reserve exploitation. Fertil Steril. 2016;105:1488–95.CrossRefPubMedGoogle Scholar
  81. 81.
    Tsampras N, Gould D, Fitzgerald CT. Double ovarian stimulation (DuoStim) protocol for fertility preservation in female oncology patients. Hum Fertil (Camb). 2017;20:248–53.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Qiuju Chen
    • 1
  • Yanping Kuang
    • 1
  1. 1.Department of Assisted ReproductionShanghai Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina

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