Natural-cycle in vitro fertilization in poor responder patients: a survey of 500 consecutive cycles

Schimberni, Mauro; Morgia, Francesco; Colabianchi, Julio; Giallonardo, Annalise; Piscitelli, Claudio; Giannini, Pierluigi; Montigiani, Monica; Sbracia, Marco

doi:10.1016/j.fertnstert.2008.07.1765

Cited by 94 publications

(69 citation statements)

References 23 publications

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“…Pregnancy rates using this approach are just 7% per cycle (Pelinck et al 2002). However, it has been suggested that women who respond poorly to exogenous gonadotrophins may be good candidates for natural cycle IVF (Schimberni et al 2008). Approximately, 10% of women undergoing ovarian stimulation for IVF will demonstrate a poor response defined as the production of fewer than four follicles (Pellicer et al 1987), and a low level of serum OE 2 (Hanoch et al 1998).…”

Section: Current Regimens For Ovarian Stimulationmentioning

confidence: 99%

“…Although more frequent in older women (40 years old or more), poor ovarian response can also occur unexpectedly in younger women. Natural cycle IVF may be therefore an alternative to ovarian stimulation or egg donation, as it has been shown to be as effective as ovarian stimulation in terms of pregnancy rates in this group of patients (Schimberni et al 2008). Furthermore, in older poor responders, natural cycle allows the retrieval of the dominant follicle only, allowing fertilisation of the putatively most competent oocyte available for retrieval.…”

Section: Current Regimens For Ovarian Stimulationmentioning

confidence: 99%

See 1 more Smart Citation

The impact of ovarian stimulation for IVF on the developing embryo

Santos¹,

Kuijk²,

Macklon³

2010

Reproduction

175

128

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The use of assisted reproductive technologies (ART) has been increasing over the past three decades, and, in developed countries, ART account for 1-3% of annual births. In an attempt to compensate for inefficiencies in IVF procedures, patients undergo ovarian stimulation using high doses of exogenous gonadotrophins to allow retrieval of multiple oocytes in a single cycle. Although ovarian stimulation has an important role in ART, it may also have detrimental effects on oogenesis, embryo quality, endometrial receptivity and perinatal outcomes. In this review, we consider the evidence for these effects and address possible underlying mechanisms. We conclude that such mechanisms are still poorly understood, and further knowledge is needed in order to increase the safety of ovarian stimulation and to reduce potential effects on embryo development and implantation, which will ultimately be translated into increased pregnancy rates and healthy offspring.

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Section: Current Regimens For Ovarian Stimulationmentioning

confidence: 99%

Section: Current Regimens For Ovarian Stimulationmentioning

confidence: 99%

The impact of ovarian stimulation for IVF on the developing embryo

Santos¹,

Kuijk²,

Macklon³

2010

Reproduction

175

128

View full text Add to dashboard Cite

show abstract

“…However, the pregnancy rate per started cycle have been observed to be relatively low (0-18.3 %) [2,3,14,[21][22][23][24]. The cumulative pregnancy rate in the population of normal responders was estimated about 20.8 % [3] and 44 % [4] only after three and nine cycles, respectively.…”

Section: Introductionmentioning

confidence: 98%

Accumulation of oocytes from a few modified natural cycles to improve IVF results: a pilot study

Greco

Litwicka

Arrivi

et al. 2013

J Assist Reprod Genet

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Purpose To evaluate the role of co-transfer of embryos derived from vitrified oocytes accumulated during the previous modified natural cycles and an embryo developed from the last one as an alternative to repetitive single embryo transfer in a fresh modified natural cycle. Methods Thirty-six patients underwent ICSI procedure with three frozen natural oocytes supplemented by a fresh one obtained from the fourth modified natural cycle. Thirty-one controls received at least three consecutive single embryo transfer in a fresh modified natural cycle. Results In the study group the oocyte retrieval, survival and total fertilization rate were 73.0 %, 78.1 %, and 64.5 %, respectively. Fifty-two embryos were transferred in 29 transfers. In the control group the oocyte retrieval and fertilization rate was 77.4 % and 83.7 %, respectively. Fifty single embryo transfers were performed. Of a total 14 pregnancies obtained in the study group 10 were defined as clinical and 4 as abortions. In the control group a total of 8 single clinical pregnancies and 2 miscarriages were encountered. The overall (20.0 % vs 48.2 %) and the clinical (16.0 % vs 34.4 %) pregnancy rate were significantly higher in the study group having cumulative embryo transfer following the oocyte accumulation. Conclusions These data demonstrate that the co-transfer of embryos derived from vitrified oocytes accumulated during the previous modified natural cycles and an embryo developed from the last fresh modified natural cycle assure an excellent clinical outcome with the overall and clinical pregnancy rate significantly higher compared to the repetitive single embryo transfer in a fresh modified natural cycle.

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“…However, the efficacy of natural IVF is hampered by the high incidence of oocyte retrieval failure (16.7-71.4%) and the relatively low pregnancy rate per embryo transfer (ET) cycle (0-23.5%) [2,4,[7][8][9][10][11]. And only effective treatment with 29.2% pregnancy per transfer by natural-cycle IVF was observed in 35 years old or younger poor responder patients by Schimberni et al (9). However, in these previous natural IVF cycles, generally, only the dominant follicle was aspirated while the other few small antral follicles were not [9].…”

Section: Introductionmentioning

confidence: 99%

“…And only effective treatment with 29.2% pregnancy per transfer by natural-cycle IVF was observed in 35 years old or younger poor responder patients by Schimberni et al (9). However, in these previous natural IVF cycles, generally, only the dominant follicle was aspirated while the other few small antral follicles were not [9]. Also, the immature oocyte retrieved from the small follicles followed by IVM has also been a successful treatment for infertile women with polycystic ovary syndrome (PCOS), and could get approximately 30% pregnancy rate [12].…”

Section: Introductionmentioning

confidence: 99%

Natural cycle IVF/IVM may be more desirable for poor responder patients after failure of stimulated cycles

Zhou

et al. 2011

J Assist Reprod Genet

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Objective To describe pregnancies and live births resulted from natural cycle IVF combined with in-vitro maturation (natural-cycle IVF/IVM) for three poor responder women after failure of stimulated cycles. Methods For case 1 and 2, the mature oocytes from aspirated follicles were inseminated by intracytoplasmic sperm injection (ICSI) immediately; immature oocytes were matured in vitro, and the embryos from mature and immature oocytes transferred on day 3 after oocyte retrieval. For case 3, 3 consecutive natural cycles were performed, in which the matured oocytes from in vivo or in vitro were vitrified in the first and second cycle, and warmed on the retrieval day of the third fresh cycle. Then the embryos resulted from vitrified-warmed and fresh oocytes were transferred. Results A total of 15 oocytes were obtained from the 7 retrieval cycles for the three cases. The case 1 was successfully pregnant at her first natural cycle, and case 2 was pregnant after two consecutive cycles. The two cases had successfully delivered and case 3 was in her ongoing pregnancy at the time of submission. Conclusion These results demonstrate that natural-cycle IVF/IVM might be a reasonable and efficient treatment alternative for poor responder patients when stimulated cycle has failed.

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Natural-cycle in vitro fertilization in poor responder patients: a survey of 500 consecutive cycles

Cited by 94 publications

References 23 publications

The impact of ovarian stimulation for IVF on the developing embryo

The impact of ovarian stimulation for IVF on the developing embryo

Accumulation of oocytes from a few modified natural cycles to improve IVF results: a pilot study

Natural cycle IVF/IVM may be more desirable for poor responder patients after failure of stimulated cycles

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