Natural IVF cycles may be desirable for women with repeated failures by stimulated IVF cycles

Summary & key facts

This report describes 33 women over age 37 (average 40.9 ± 3.5) who had failed repeated stimulated IVF and entered a natural-cycle IVF program. Oocytes were retrieved in 20 cycles and embryos were transferred in 16 cycles. Three cycles resulted in ongoing pregnancies past 9 weeks and all three delivered healthy babies. One pregnancy used a drug (GnRH agonist) to trigger the egg release; the other two came from completely natural cycles. The authors say natural-cycle IVF might be an option after repeated stimulated-IVF failure, but the study is small and not a controlled trial.

Key facts:

• 33 women over age 37 (mean age 40.9 ± 3.5 years) who had repeatedly failed stimulated IVF were enrolled in a natural-cycle IVF program.
• Oocytes were retrieved in 20 cycles, and embryos were transferred in 16 cycles across the program.
• Three cycles produced ongoing pregnancies (defined as past 9 weeks) and resulted in live births.
• In case 1 a GnRH agonist (Suprecur 1,200 μg) was given to trigger an LH surge; retrieval 33 hours later yielded one mature (M-II) oocyte that was fertilized by ICSI and led to a 2,958 g male infant delivered at 40 weeks.
• Cases 2 and 3 resulted from completely natural cycles where an endogenous LH surge was observed or was descending before ovulation; these led to live births of 2,900 g and 3,838 g females, respectively.
• The authors note known problems with natural-cycle IVF: a high cancellation rate mainly because of untimely LH surge and the risk of empty follicles (no oocyte retrieved).
• The paper is a small, uncontrolled case series; the authors state no randomized controlled trials are available comparing natural versus stimulated IVF for older patients after repeated stimulated-IVF failures.

Topics

Assisted Reproductive Technology and Twin Pregnancy Ovarian function and disorders Reproductive Biology and Fertility

Categories

Health Sciences Medicine Public Health, Environmental and Occupational Health

Tags

Anatomy Andrology Biology Cell biology Embryo Embryo transfer Endocrinology Follicle-stimulating hormone Genetics Gestation Gonadotropin Gynecology Hormone Human fertilization In vitro fertilisation Luteinizing hormone Medicine Natural cycle Oocyte Ovulation Ovulation induction Pregnancy