Does Oocyte Retrieval Performance in Mono-follicular Cycles Differ by Physician Experience?

Ertaş, Sinem; Urman, Bülent; Yakın, Kayhan

doi:10.1007/s43032-022-00971-6

Cited by 1 publication

(1 citation statement)

References 18 publications

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“…Among them, those with a single dominant follicle are of particular difficulty since both the quality and quantity of the oocytes are reduced [ 3 ]. Monofollicular IVF cycles were reported to have an oocyte retrieval rate of about 80% [ 4 , 5 ] and a fertilization rate of 63.9%, while the viable embryo rate was as low as 28–62.7%, the implantation rate was 9.5–15% and the live birth rate was 2.6–8.4% per stimulation cycle [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Preventing Growth Stagnation and Premature LH Surge Are the Keys to Obtaining a Viable Embryo in Monofollicular IVF Cycles: A Retrospective Cohort Study

Guo

Zhu

et al. 2022

JCM

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How LH levels influenced the outcomes of monofollicular IVF cycles using different stimulation protocols was controversial. In this single-center, retrospective study, we analyzed 815 monofollicular IVF cycles between 2016–2022 using natural cycle (NC), medroxyprogesterone acetate (MPA) or clomiphene citrate (CC) in addition to human menopausal gonadotropin (hMG), with or without GnRH antagonist. A viable embryo was obtained in 35.7% of all cycles. Growth stagnation and premature LH surge are two markedly negative factors for obtaining viable embryos (odds ratios of 0.12 [0.08–0.65], p < 0.0001 and 0.33 [0.26,0.42], p < 0.0001, respectively). NC/hMG cycles are prone to premature LH surge (40.4%), yielding a significantly lower opportunity of obtaining embryos (24.7%, p = 0.029). The administration of GnRH antagonist on the background of MPA resulted in a significant decrease in LH levels (from 2.26 IU/L to −0.89 IU/L relative to baseline, p = 0.000214), leading to a higher risk of growth stagnation (18.6%, p = 0.007). We hypothesized that the abrupt decline of LH might increase the risk of apoptosis in granulosa cells. We proposed a “marginal effect” framework to emphasize that the change of LH was the key to its bioactivity, rather than the traditional “window” concept with fixed cutoff values of a threshold and a ceiling.

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