A study by Instituto Bernabeu determines that the starting day of hormone treatment does not affect the effectiveness of fertility treatment.

The Journal “RBM Online” has published the results of a study by Instituto Bernabeu which concludes that there are no significant differences in the efficacy of clinical outcomes between oocytes obtained by conventional ovarian stimulation and the random-start protocol. Ovarian stimulation aims to induce the development of multiple follicles in a woman’s ovaries to increase the chances of obtaining several mature eggs in a single menstrual cycle and, traditionally, hormonal treatment for this purpose begins between the first and third day of the menstrual cycle (in the so-called early follicular phase).

However, alternatively, in recent years another strategy has been proposed that makes it possible to start regardless of the day of the woman’s cycle (this strategy has become known as the random-start protocol). Initially, this protocol was aimed at fertility preservation oncology patients, as it significantly reduced the time required to cryopreserve their oocytes before starting treatment for the disease, although there are other groups of patients who could also benefit from its use, such as oocyte donors.

The study results have revealed that there are no significant differences in the treatment’s efficacy, taking into account aneuploidy rates, clinical pregnancy, miscarriage and live births in recipient patients who receive oocytes donated after conventional stimulation or following the random-start protocol. Jaime Guerrero, the Oocyte Donation and Cryobiology Programme Director at Instituto Bernabeu, highlighted the importance of finding simpler and more convenient treatments for patients, pointing out that the random-start protocol “is already routinely implemented in the Instituto Bernabeu oocyte donation programme, which substantially simplifies the clinical and laboratory processes”.

The benefits for patients are remarkable, as the implementation of this protocol allows for a significant reduction in the waiting time to start ovarian stimulation. By being able to start treatment an any time, donors do not have to adjust to the specific timing of the menstrual cycle, which is particularly beneficial in situations where their availability is limited, as well as facilitating synchronisation between egg donors and recipients.

Random-start ovarian stimulation in an oocyte donation programme: a large, single-centre, experience

J. Guerrero, J.C. Castillo, J. Ten, F. Quereda, A. Bernabeu, R. Bernabeu