# Effect of Prolonged Ovarian Stimulation (24 and 48 Hours) Compared to Conventional Duration on IVF/ICSI Outcomes: A Single-Blind Randomized Clinical Trial: Effect of Prolonged Ovarian Stimulation on IVF/ICSI

## TL;DR

This study compared extended ovarian stimulation durations in IVF/ICSI and found no significant differences in pregnancy outcomes compared to conventional protocols.

## Contribution

The study is the first to evaluate 24 and 48-hour prolonged ovarian stimulation in a randomized clinical trial for IVF/ICSI outcomes.

## Key findings

- No significant differences in pregnancy rates were found between prolonged and conventional ovarian stimulation.
- AFC and AMH levels were positively correlated with pregnancy outcomes and follicle/oocyte/embryo counts.
- A trend toward improved outcomes was observed with longer stimulation, though not statistically significant.

## Abstract

Background: Infertility is a global public health concern, and controlled
ovarian stimulation (COS) plays a crucial role in assisted reproductive
technologies (ART) by facilitating the retrieval of multiple oocytes. This
single-blind randomized clinical trial aimed to evaluate whether extending
the duration of COS by 24 and 48 hours beyond the conventional protocol
would affect pregnancy rates in couples undergoing IVF/ICSI.

Materials and Methods: Ninety patients were randomized into three groups:
control (GC), 24-hours longer (G24), and 48-hours longer (G48), using block
randomization. The GC group followed the standard COS protocol, while G24
and G48 received extended COS for their respective durations. Primary
outcomes included imaging-proven pregnancy at six weeks gestation, chemical
pregnancy, and clinical pregnancy post-embryo transfer. Secondary outcomes
included follicle, oocyte, and embryo counts.

Results: Baseline characteristics were comparable across groups. Antral
follicle count (AFC) and anti-Müllerian hormone (AMH) levels were positively
correlated with pregnancy outcomes. Significant associations were observed
between AFC/AMH and follicle/oocyte/embryo counts. Although embryo counts
varied among groups, no significant differences in primary or secondary
outcomes were found. A trend towards improved outcomes was noted from GC to
G48, but without statistical significance.

Conclusion: The study did not find significant differences in pregnancy rates
or other outcomes with prolonged COS durations compared to conventional
protocols. However, the results suggest a need for further research to
explore the effects of extended COS in specific patient subsets, as existing
literature indicates potential benefits.