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Larger oocyte cohorts maximize fresh IVF cycle birth rates and availability of surplus high-quality blastocysts for cryopreservation
- Source :
- Reproductive biomedicine online. 38(5)
- Publication Year :
- 2017
-
Abstract
- How does oocyte cohort size affect IVF treatment outcomes?Retrospective cohort analysis of 10,193 fresh autologous oocyte retrievals among good-prognosis patients35 years from 2009 to 2015. The primary outcome was live birth from a fresh transfer; secondary outcomes included cumulative live birth potential from the retrieved cohort and frequency of severe ovarian hyperstimulation syndrome (OHSS).Live birth per fresh transfer increased as the oocyte cohort increased up to 11-15 oocytes, then plateaued. Beyond 15 oocytes, live birth rates from fresh transfer did not decrease, even at the highest oocyte yields. When accounting for the availability of cryopreserved high-quality supernumerary blastocysts, the cumulative number of potential live births per retrieval continued to increase as oocyte yield increased. Rates of severe OHSS increased rapidly with increasing cohort size above 7-10 oocytes when final oocyte maturation was triggered with human chorionic gonadotrophin (HCG), up to nearly 7% of HCG-triggered retrievals of25 oocytes, but when triggered with gonadotrophin-releasing hormone (GnRH) agonist the severe OHSS rate remained relatively low and stable at approximately 1% even among retrievals of the largest oocyte cohorts.Live birth rates per fresh embryo transfer are highest among cycles with retrieval of 11 or more oocytes. Larger cohorts are not associated with any decline in fresh transfer birth rates. Total potential births per retrieval continue to increase as the number of retrieved oocytes increases. Rates of OHSS remain relatively low after retrieval of large oocyte cohorts if final maturation is triggered with GnRH agonist rather than HCG.
- Subjects :
- 0301 basic medicine
Adult
Pregnancy Rate
Ovarian hyperstimulation syndrome
Oocyte Retrieval
Fertilization in Vitro
Biology
Cryopreservation
Birth rate
Andrology
03 medical and health sciences
Ovarian Hyperstimulation Syndrome
0302 clinical medicine
Embryo cryopreservation
Ovulation Induction
Pregnancy
medicine
Humans
Retrospective Studies
030219 obstetrics & reproductive medicine
Obstetrics and Gynecology
Retrospective cohort study
medicine.disease
Oocyte
030104 developmental biology
medicine.anatomical_structure
Blastocyst
Reproductive Medicine
Cohort
Female
Live birth
Developmental Biology
Subjects
Details
- ISSN :
- 14726491
- Volume :
- 38
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Reproductive biomedicine online
- Accession number :
- edsair.doi.dedup.....0678c23455aa5e7ab6c0b2921178f4d1