title: Aspiration of a single dominant follicle leads to improved cohort development and pregnancy in a patient with poor response to in vitro fertilization treatment.
abstract: OBJECTIVE
  To report improved follicular cohort development and a healthy ongoing pregnancy after midcycle aspiration of a single dominant ovarian follicle in a patient with poor response to IVF treatment.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University-based infertility center.
  
  
  METHODS
  A 39-year-old woman (gravida 1, para 0) with a borderline FSH level and four previous unsuccessful IVF attempts.
  
  
  METHODS
  A single 27-mm follicular cyst was aspirated after 13 days of treatment, while controlled ovarian hyperstimulation was continued.
  
  
  METHODS
  Number of follicles developed, number of oocytes retrieved, development of a clinical pregnancy.
  
  
  RESULTS
  In previous attempts, the patient had no more than two dominant follicles and a maximum of three oocytes retrieved. After midcycle aspiration of the single lead follicle, a new cohort of seven follicles developed and seven oocytes were recovered. Six embryos were replaced by tubal ET and an ongoing singleton gestation resulted.
  
  
  CONCLUSIONS
  Midcycle aspiration of a single lead follicle in a patient with poor response to IVF treatment allowed the development of a larger secondary cohort of follicles during the same cycle and ultimately led to a viable pregnancy. This intervention may have future implications for the treatment of poor responders.
authors.affiliation: Department of Gynecology and Obstetrics, Stanford University School of Medicine, California 94305, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Fisch
authors.forename: A A
authors.initials: AA
authors.lastname: Milki
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008597:Menstrual Cycle; D008845:Microinjections; D009865:Oocytes / Q000502:physiology; D006080:Ovarian Follicle / Q000166:cytology*; D010062:Ovulation Induction; D011247:Pregnancy; D013396:Suction; D017211:Treatment Failure
chemical_list: D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone