Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome.
Three hundred and twenty-seven consecutive in-vitro fertilization (IVF) cycles in which luteal-phase leuprolide had been given were ranked according to the number of pre-ovulatory oocytes obtained (1-5, 6-10, greater than 10). Excess pre-embryos were cryopreserved at the pronuclear stage and later transferred into monitored natural cycles on the day after ovulation. The results indicate that the retrieval of large numbers of pre-ovulatory oocytes (greater than 10) has a small negative impact on oocyte quality as judged by fertilization rates (4% lower). However, implantation was not impaired compared to lower levels of retrieval in either the original IVF or subsequent cryo-thaw cycles. Overall, despite the small reduction in fertilization rate, the retrieval of many pre-ovulatory oocytes has produced a 'take-home baby rate' per stimulation cycle of 28.3% when 6-10 pre-ovulatory oocytes were retrieved and 41.5% when greater than 10 were retrieved: even higher rates are anticipated when the remaining cryopreserved pre-embryos are ultimately thawed.
Toner
J P
JP
Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk 23507.
Brzyski
R G
RG
Oehninger
S
S
Veeck
L L
LL
Simonetti
S
S
Muasher
S J
SJ
D000328:Adult; D002452:Cell Count / Q000187:drug effects; D015925:Cryopreservation; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005498:Follicular Phase / Q000502:physiology*; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D016729:Leuprolide; D009865:Oocytes / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome
D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide