Comparison of IVF/ICSI outcomes of luteal-phase stimulation after oocyte retrieval in natural cycle or natural ovulation in poor ovarian responders
Objective To compare the clinical outcomes of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)of luteal-phase stimulation after oocyte retrieval in natural cycle or natural ovulation in poor ovarian respond-ers.Methods Totally 418 poor ovarian response patients who underwent IVF/ICSI with luteal-phase stimulation were se-lected.They were divided into two groups based on whether the dominant follicle in the natural cycle was retrievaled or not.Among them,169 cases underwent luteal-phase stimulation after oocyte retrieval in natural cycle(Group A),and 249 cases underwent luteal-phase stimulation after natural ovulation(Group B).We compared the numbers of oocytes re-trieved,mature oocytes,2 pronuclcus(2PN)fertilizations,frozen blastocysts,blastocysts of development on the 5th day(D5 blastocysts),and the proportions of non-oocyte and non-frozen blastocyst between the two groups with luteal-phase stimulation.We recorded the oocyte retrieval rate and blastocyst frozen rate of natural cycle,and the total numbers of oo-cytes retrieved and frozen blastocysts obtained from the natural cycle and luteal-phase stimulation in the Group A.We com-pared the days of stimulation and total additional doses of gonadotropin(Gn)of luteal-phase stimulation,and the biochemi-cal pregnancy rate,clinical pregnancy rate,early miscarriage rate,live birth rate of the first transplantation of frozen blas-tocyst which was obtained from the luteal-phase stimulation between the two groups.Results Compared with Group A,the Group B had significantly larger numbers of oocytes retrieved,mature oocytes,2PN fertilizations,and frozen blasto-cysts with luteal-phase stimulation(all P<0.05);the proportion of non-frozen blastocyst with luteal-phase stimulation in the Group A was significantly higher than that in the Group B(P<0.05).There were no significant differences in the num-bers of D5 blastocysts or the proportions of non-oocyte with luteal-phase stimulation between the Group A and Group B(all P>0.05).In the Group A,the oocyte retrieval rate of natural cycle was 72.78%(123/169),with an average of one oo-cyte retrieved per case;the blastocyst frozen rate of natural cycle was 22.49%(38/169),and all cases obtained one fro-zen blastocyst each.The total number of Group A of oocytes retrieved was 4(3,7)and the total number of frozen blasto-cysts was 2(1,3),while the numbers of Group B were 5(3,8)and 2(1,3),with no significant difference(all P>0.05).No significant differences were found in the days of stimulation,total additional doses of Gn,the biochemical preg-nancy rate,clinical pregnancy rate,early miscarriage rate,or live birth rate of the first transplantation of frozen blastocyst which was obtained from the luteal-phase stimulation(all P>0.05).Conclusions The overall numbers of oocytes re-trieved and frozen blastocysts of poor ovarian responders with oocyte retrieval in natural cycle and natural ovulation are sim-ilar,as well as the embryo quality and the IVF/ICSI outcomes of the subsequent luteal-phase stimulation.However,there are larger numbers of oocytes retrieved and frozen blastocysts of luteal-phase stimulation after natural ovulation in patients with poor ovarian response.
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