The latest marketing fad in IVF is called  Duostim. What is it? Who might benefit from  
The latest marketing fad in IVF is called  Duostim. What is it? Who might benefit from  

Duostim? Most importantly, what does the  data say? Stay tuned and I will explain.
Duostim? Most importantly, what does the  data say? Stay tuned and I will explain.

The key to successful IVF is the  ability to mature and retrieve  
The key to successful IVF is the  ability to mature and retrieve  

multiple eggs from the ovaries. This is done  using fertility medications of various types.  
multiple eggs from the ovaries. This is done  using fertility medications of various types.  

For a variety of reasons, some people respond  to these medications better than others.  
For a variety of reasons, some people respond  to these medications better than others.  

Watch this video for more information  about the reasons this happens.
Watch this video for more information  about the reasons this happens.

One of the more frustrating groups that fertility  doctors encounter are people who do not respond  
One of the more frustrating groups that fertility  doctors encounter are people who do not respond  

to fertility medications very well. These people,  known as poor responders, are more likely to have  
to fertility medications very well. These people,  known as poor responders, are more likely to have  

their IVF attempt canceled before reaching egg  retrieval. When eggs are retrieved, they don’t get  
their IVF attempt canceled before reaching egg  retrieval. When eggs are retrieved, they don’t get  

as many eggs. Less eggs means less embryos. Less  embryos means less opportunities to find healthy  
as many eggs. Less eggs means less embryos. Less  embryos means less opportunities to find healthy  

viable embryos. This is part of the reason  why pregnancy rates in this group are so low.
viable embryos. This is part of the reason  why pregnancy rates in this group are so low.

Over the years, there have been a number of  different protocols offered for people who are  
Over the years, there have been a number of  different protocols offered for people who are  

poor responders. You have probably heard of  some of these. The two important things to  
poor responders. You have probably heard of  some of these. The two important things to  

remember about all of these protocols is  that none of them work very effectively  
remember about all of these protocols is  that none of them work very effectively  

and none of them have ever been shown to  work any better than any other protocol.
and none of them have ever been shown to  work any better than any other protocol.

As a result, doctors and scientists are  always l--ooking for new protocols to  
As a result, doctors and scientists are  always l--ooking for new protocols to  

help this group of patients. Poor responder  IVF patients are desperate to have a child  
help this group of patients. Poor responder  IVF patients are desperate to have a child  

and will believe anything that  anybody tells them might be better.  
and will believe anything that  anybody tells them might be better.  

Into this perfect storm of  desperation comes Duostim.
Into this perfect storm of  desperation comes Duostim.

Traditionally, doctors would start fertility  medications within a few days of when a period  
Traditionally, doctors would start fertility  medications within a few days of when a period  

begins. This was based on how eggs mature  naturally. Several years ago, however, doctors  
begins. This was based on how eggs mature  naturally. Several years ago, however, doctors  

in Japan found that you could start fertility  medications at other times of the cycle, such as  
in Japan found that you could start fertility  medications at other times of the cycle, such as  

after ovulation and there would still be immature  eggs that would respond to the medications.  
after ovulation and there would still be immature  eggs that would respond to the medications.  

This discovery was very welcome for cancer  patients who wanted to complete an egg retrieval  
This discovery was very welcome for cancer  patients who wanted to complete an egg retrieval  

for fertility preservation. Speed is so important  for this group of patients. Their oncologists were  
for fertility preservation. Speed is so important  for this group of patients. Their oncologists were  

anxious to have them start their cancer treatment.  Waiting for their period to come to start  
anxious to have them start their cancer treatment.  Waiting for their period to come to start  

fertility medications could cause delays of weeks.  Now, fertility specialists could start their  
fertility medications could cause delays of weeks.  Now, fertility specialists could start their  

fertility medication at other times of the cycle.  This is now known as a “random” cycle start.
fertility medication at other times of the cycle.  This is now known as a “random” cycle start.

Conclusion number 1. It is possible  to mature eggs by starting fertility  
Conclusion number 1. It is possible  to mature eggs by starting fertility  

medications at a non traditional time
medications at a non traditional time

People that are doing an egg retrieval for  fertility preservation would also like to  
People that are doing an egg retrieval for  fertility preservation would also like to  

have as many eggs as possible but, as I said  before, they are short on time. Some doctors tried  
have as many eggs as possible but, as I said  before, they are short on time. Some doctors tried  

something new. They would stimulate the ovaries  once in the usual way but then, several days after  
something new. They would stimulate the ovaries  once in the usual way but then, several days after  

the egg retrieval, they would start stimulating  the ovaries again. Guess what? It worked. They  
the egg retrieval, they would start stimulating  the ovaries again. Guess what? It worked. They  

were able to get more eggs in a shorter amount of  time by doing two egg retrievals closer together.
were able to get more eggs in a shorter amount of  time by doing two egg retrievals closer together.

Conclusion number 2. Duostim appears to be  a reasonable option for cancer patients who  
Conclusion number 2. Duostim appears to be  a reasonable option for cancer patients who  

want to complete multiple attempts of fertility  preservation rapidly before starting chemotherapy.
want to complete multiple attempts of fertility  preservation rapidly before starting chemotherapy.

Next, some doctors tried using Duostim  for people that were poor responders.  
Next, some doctors tried using Duostim  for people that were poor responders.  

A number of claims started popping up on websites  and social media claiming that Duostim was a  
A number of claims started popping up on websites  and social media claiming that Duostim was a  

“better” protocol for poor responders that would  produce “more eggs” of “better quality” and thus  
“better” protocol for poor responders that would  produce “more eggs” of “better quality” and thus  

result in more pregnancies. None of these  claims are currently supported by the data.
result in more pregnancies. None of these  claims are currently supported by the data.

Let’s look at the “more eggs” claim. Small studies  claiming this benefit would analyze the number of  
Let’s look at the “more eggs” claim. Small studies  claiming this benefit would analyze the number of  

eggs obtained after two egg retrievals using  duostim compared with one egg retrieval. Can  
eggs obtained after two egg retrievals using  duostim compared with one egg retrieval. Can  

you get more eggs from two egg retrievals compared  to one? Yes. Would it be the same if you performed  
you get more eggs from two egg retrievals compared  to one? Yes. Would it be the same if you performed  

two egg retrievals in the traditional way compared  to using Duostim? Most likely. Importantly,  
two egg retrievals in the traditional way compared  to using Duostim? Most likely. Importantly,  

none of the proponents of Duostim have  ever published results of studies showing  
none of the proponents of Duostim have  ever published results of studies showing  

two retrievals using Duostim produced more eggs  than two retrievals done with traditional timing.
two retrievals using Duostim produced more eggs  than two retrievals done with traditional timing.

In fact, when you look at all of the  Duostim studies, there is no evidence  
In fact, when you look at all of the  Duostim studies, there is no evidence  

that poor responding patients respond any better  with duostim than other protocols. There is no  
that poor responding patients respond any better  with duostim than other protocols. There is no  

evidence that the quality of the eggs is any  better or that more pregnancies will result.
evidence that the quality of the eggs is any  better or that more pregnancies will result.

Our InfertilityTV Bottom line is this. If you are  in desperate need to complete two egg retrievals  
Our InfertilityTV Bottom line is this. If you are  in desperate need to complete two egg retrievals  

in a shorter period of time, such as a cancer  patient who needs to start chemotherapy, Duostim  
in a shorter period of time, such as a cancer  patient who needs to start chemotherapy, Duostim  

is a reasonable option to discuss with your  doctor. If you are a poor responding IVF patient,  
is a reasonable option to discuss with your  doctor. If you are a poor responding IVF patient,  

attempting more egg retrievals to get more  eggs and more embryos is a reasonable goal.  
attempting more egg retrievals to get more  eggs and more embryos is a reasonable goal.  

However, there is currently no  data that suggests that duostim  
However, there is currently no  data that suggests that duostim  

is a better option for doing this  compared to any other method.
is a better option for doing this  compared to any other method.