Outcome of in-vitro fertilization through natural cycles in poor responders

Abstract

This prospective study examines the benefits of using natural cycles instead of stimulated cycles in poor responders to in-vitro fertilization (IVF) treatment. Eleven patients in whom puncture was cancelled or who failed to conceive because of a poor response were included in the analysis. The data for natural cycles (n = 16) were compared with data obtained during previous stimulated cycles (n = 25) in the same women. Out of 16 natural cycles, 13 (81.3%) were scheduled for oocyte retrieval compared to 13 out of 25 stimulated cycles (52%). Eighteen metaphase II oocytes were obtained during stimulated cycles, giving a 66% fertilization rate. In natural cycles, 11 metaphase II oocytes were available giving a fertilization rate of 78.6%. A mean number of 51.5 +/- 25 ampoules of gonadotrophins per cycle were used during ovarian stimulation. Three clinical pregnancies were obtained after embryo transfer in natural cycles (18.8%/started cycle) compared to none in stimulated cycles. Our findings demonstrate that an encouraging number of pregnancies can be achieved by IVF during natural cycles in poor responders to ovarian stimulation. This may not be the first approach to consider in IVF but it should be offered as an alternative after two ovarian response failures using classical protocols of stimulation.

The clinical analysis of poor ovarian response in in-vitro-fertilization embryo-transfer among Chinese couples

“…Women aged >40 years of poor ovarian response can be considered to have donor oocytes or to undergo natural IVF cycle. Natural IVF cycle without/with minimal stimulation can be considered as an easy and cheap approach in the management of poor responder patients [27,28].…”

Different ovarian stimulation protocols for women with diminished ovarian reserve

“…The results of two prospective studies [171,178] support the hypothesis that the naturally developed follicles of poor responders may produce fewer oocytes but oocytes of better quality than their hyperstimulated ovaries. It is clear that, in poor responders, natural cycle is superior once an oocyte has been retrieved and fertilization and implantation rates are significantly better.…”

“…In a review by Pelenck and collegues [170], the cancellation rate in natural cycles was reported to range from 14.3 to 62.5%. Natural cycles in IVF have been used for patients who have shown a poor response in at least two previous attempts with gonadotropin stimulation [171]. It has been suggested in recent years that IVF following a natural cycle may be a promising alternative for poor responders [172].…”

IVM is an alternative for patients with PCO after failed conventional IVF attempt

“…Therefore there is an increasing desire for milder ovarian stimulation using either lower amounts of gonadotropins, or, ideally, dispensing with ovarian stimulation altogether [14]. An alternative approach is to use natural cycle IVF [15]. However, since there is generally only one preovulatory follicle in a natural cycle, many women will not have an oocyte collection or embryo transfer [15].…”

“…An alternative approach is to use natural cycle IVF [15]. However, since there is generally only one preovulatory follicle in a natural cycle, many women will not have an oocyte collection or embryo transfer [15]. It has been shown that IVM is a successful method of treatment in women who have polycystic ovarian syndrome [3,7,16].…”