{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:43:58Z","timestamp":1790369038539,"version":"4.1.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate DuoStim strategy across a decade from its clinical implementation in IVF by comparing embryological and clinical outcomes between the first and second ovarian stimulations (1st-OS and 2nd-OS) conducted within 30 days, focusing on treatment efficiency and time-to-conclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective single-center study (2015\u20132024) including 1656 poor-prognosis patients undergoing 1896 DuoStim cycles planned for ICSI and PGT-A at the blastocyst stage. Poor prognosis was defined as very advanced maternal age (\u226540 years) and\/or reduced ovarian reserve (AMH \u22641.2 ng\/mL, AFC \u22645, or \u22643 oocytes in previous retrievals). Endpoints included all embryological, clinical and neonatal outcomes comparing 2nd-OS versus 1st-OS and cumulatively. Among 1561 concluded first DuoStim cycles, we calculated time-to-treatment-conclusion (TTC), stratified as without a live-birth (TTC-noLB) and with a live-birth (TTC-LB), and treatment discontinuation at our center after a first failed DuoStim attempt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The use of DuoStim increased over time, reaching 34% of all cycles in 2024. The 2nd-OS yielded more oocytes and embryos than 1st-OS, while their competence was comparable. Consequently, the 2nd retrieval provided a cumulative incremental yield of 66% for cycles achieving \u22651 euploid blastocyst and 125% for cycles achieving \u22651 live birth (LB) compared with the 1st-OS alone. Median TTC was 40 days (quartile-1: 36, quartile-3: 118.5), while TTC-noLB and TTC-LB were 38 days (quartile-1: 35, quartile-3: 41.5) and 145 days (quartile-1: 112.25, quartile-3: 221), respectively. Embryological and clinical outcomes were stable across the years. Treatment discontinuation among patients without a LB after a first completed DuoStim decreased from 61% in 2015 to 44% in 2021, as second DuoStim attempts increased from 16% to 21% and transition to egg donation from 9% to 21%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DuoStim is a multicycle stimulation strategy that represents an alternative approach for patients requiring multiple treatment opportunities within a short timeframe. It shifts IVF toward a flexible personalized journey for poor prognosis patients. By enabling two stimulations within a single ovarian cycle, it achieved a cumulative live birth rate of 28.5% per concluded cycle in our cohort, within a consistently short timeframe in terms of both TTC-noLB and TTC-LB. Overall, DuoStim represents a treatment strategy that supports rapid and effective clinical decision-making in time-sensitive patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1854570","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:44Z","timestamp":1787027324000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ten years of DuoStim in time-sensitive poor-prognosis IVF patients: real world cumulative outcomes and treatment trajectories"],"prefix":"10.3389","volume":"17","author":[{"given":"Filippo Maria","family":"Ubaldi","sequence":"first","affiliation":[{"name":"Genera, Clinica Valle Giulia, IVIRMA Global Research Alliance","place":["Rome, Italy"]},{"name":"Department of Pharmacy, Health and Nutritional Sciences, University of Calabria","place":["Rende, 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Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Genera, Clinica Valle Giulia, IVIRMA Global Research Alliance","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Ruffa","sequence":"additional","affiliation":[{"name":"Genera, Clinica Valle Giulia, IVIRMA Global Research Alliance","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Pittana","sequence":"additional","affiliation":[{"name":"Genera, Clinica Valle Giulia, IVIRMA Global Research Alliance","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Magna Graecia","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Ferrero","sequence":"additional","affiliation":[{"name":"Genera, Clinica Valle Giulia, IVIRMA Global Research Alliance","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Morelli","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Health and Nutritional Sciences, University of Calabria","place":["Rende, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Guido","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Health and Nutritional Sciences, University of Calabria","place":["Rende, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rienzi","sequence":"additional","affiliation":[{"name":"IVIRMA Italia, IVIRMA Global Research Alliance","place":["Rome, Italy"]},{"name":"Department of Biomolecular Sciences, University of 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