Oocyte retrieval timing based on spontaneous LH surge during natural cycle IVF

Описание: Capsule:
In ncIVF treatment OR scheduling based on the occurrence of spontaneous LH surge yields acceptable oocyte recovery, fertilization, and embryo cleavage rates.

Authors:
Daniel Bodri, M.D., M.Sc., Ph.D., Satoshi Kawachiya, M.D., Masae Kondo, M.Sc., Ryutaro Kato, M.Sc., Tsunekazu Matsumoto, M.D., Ph.D.

Volume 101, Issue 4, Pages 1001-1007.e2

Abstract:

Objective:
To determine the efficiency of oocyte retrieval (OR) timing based on the occurrence of spontaneous LH surge during natural cycle IVF (ncIVF) treatment.

Design:
Retrospective cohort study. The cohort was divided into five subgroups according to the presumed stage of spontaneous LH surge on scheduling day (1A: before onset; 1B: surge start; 2: ascending slope; 3: peak; and 4: descending slope).

Setting:
Private infertility clinic.

Patient(s):
Three hundred sixty-five infertile patients who underwent 1,138 ncIVF treatment cycles during 2008--2011.

Intervention(s):
Drug-free ncIVF treatment.

Main Outcome Measure(s):
Rate of successfully retrieved, fertilized oocytes, cleaved embryos, and live births per scheduled oocyte retrieval.

Result(s):
In 61% of the cycles OR was scheduled before or just at the start of the LH surge (groups 1A--1B), whereas in the remaining cases it was scheduled after the surge had already started (groups 2--4). The proportion of cycles with successfully recovered (range, 71%--86%), inseminated (range, 61%--78%), fertilized oocytes (range, 47%--68%), cleaved embryos (range, 45%--66%), and live births (range, 4.1%--9.2%) was not significantly different among subgroups.

Conclusion(s):
In ncIVF treatment OR timing based on the occurrence of spontaneous LH surge is feasible, yielding acceptable oocyte recovery, fertilization, and embryo cleavage rates. This strategy combined with a rapid and low-risk OR procedure permits the management of a large ncIVF program on a 7-days-per-week basis within working hours.