When to Start Stimulation

Traditionally, IVF stimulation started on cycle day 2–3. Now, random-start ovarian stimulation allows starting on any day of the cycle.

Conventional Protocol

• Start medication cycle day 2–3
• Follicular phase stimulation
• 10–12 days duration
• One cycle per menstrual cycle

Random-start Protocol

• Start any day — early follicular, late follicular, or luteal phase
• Enables DuoStim (2 rounds in 1 cycle)
• Ideal for: fertility preservation before chemo, poor responders, tight schedules

Comparative Outcomes

Meta-analyses show no significant difference in egg yield, blastocyst formation, or pregnancy rates between the two protocols.

Who Benefits from Random-start

• Cancer patients needing egg freezing before chemotherapy
• Poor responders considering DuoStim
• Patients with tight schedules or travel constraints
• Very irregular cycles