Luteal phase ovarian stimulation in women with diminished ovarian reserve

John Zhang


Women with diminished ovarian reserve (DOR) have poor response to controlled ovarian stimulation, which results in low or no oocytes retrieved leading to low pregnancy rates. Studies in humans and animals have shown that folliculogenesis occurs in a wave-like fashion where there are multiple follicular recruitment waves in the same menstrual cycle. More specifically, small antral follicles in the luteal phase may be in early stages of follicular development rather than in a phase of atresia. These antral follicles observed in the luteal phase can produce healthy follicles if stimulated with medications and the resulting oocytes retrieved are competent to produce healthy embryos and ultimately healthy babies. This manuscript summarizes data showing the feasibility of initiating ovarian stimulation during the luteal phase with good pregnancy outcomes following frozen embryo transfer. The data to date indicate that the use of luteal phase ovarian stimulation following oocyte retrieval in the same cycle represents a promising new approach for patients with DOR.


IVF; ovarian stimulation; luteal phase; low ovarian reserve

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