Conventional ovarian stimulation and single embryo transfer for IVF/ICSI. How many oocytes do we need to maximize cumulative live birth rates after utilization of all fresh and frozen embryos?

Abstract

No external funding was used for this study. No conflicts of interest are declared.

Freeze-all cycle for all normal responders?

“…While in our study, the cryopreservation and thawing procedures were performed on day 3; it is still unclear which developmental embryo stage yielded better results when performing the freeze-all cycle [34,35]. Recent studies suggest that a stricter segmentation based on ovarian response could be related to a better prediction of IVF outcomes [29,30]. The authors of those studies considered the following categories of responders: poor (1-3 retrieved oocytes), suboptimal (4-9 oocytes), normal (10-15 oocytes), and high (>15 oocytes).…”

“…The authors of those studies considered the following categories of responders: poor (1-3 retrieved oocytes), suboptimal (4-9 oocytes), normal (10-15 oocytes), and high (>15 oocytes). In the study by Drakopoulos et al [30], the authors correlated these groups with the live birth rates and cumulative live birth rate, following a fresh embryo transfer. There are also new data suggesting that a novel patient stratification approach using low-prognosis patients may help improve the management of IVF patients [36]; however, these proposed stratification methods take into account only the number of retrieved oocytes and ovarian reserve tests as outcome predictors.…”

“…The iET can also avoid unnecessarily submitting suboptimal responders to this strategy, which would lead to an unnecessary increase in treatment costs and delays in the embryo transfer. Previous studies have evaluated live birth rates in a fresh cycle, as well as cumulative live birth rates, correlating these outcomes to ovarian response [30,40]. The authors of these studies observed that when stratifying patients by the number of retrieved oocytes, the live birth rate following a fresh embryo transfer fails to increase when over 10-11 oocytes are retrieved.…”

“…Ongoing pregnancy was defined as a pregnancy that completed at least 12 weeks of gestation. Normal responders were divided into one of two groups according to the number of retrieved oocytes: Group 1 (4-9 oocytes)-suboptimal responders and Group 2 (10-15 oocytes)-normal responders, based on a new suggested stratification [29,30]. Age, basal FSH level, antral follicle count (AFC), the number of retrieved and mature (MII) oocytes, the number of 2PN, the number of transferred embryos, and cycle type (freeze-all vs. fresh) were included in the analysis.…”

Efficacy of Follicle-Stimulating Hormone (FSH) Alone, FSH + Luteinizing Hormone, Human Menopausal Gonadotropin or FSH + Human Chorionic Gonadotropin on Assisted Reproductive Technology Outcomes in the “Personalized” Medicine Era: A Meta-analysis

“…Continuing until pregnancy and live birth rate, each step is influenced by a number of factors, not immediately dependent on gonadotropins. Accordingly, the relationship between live birth rate and oocytes retrieved is suggested in the literature (15), but not universally accepted (16, 17). For these reasons, it is not possible to identify a unique endpoint to evaluate COS outcomes.…”