Modified natural cycle for IVF does not offer a realistic chance of parenthood in poor responders with high day 3 FSH levels, as a last resort prior to oocyte donation.
BACKGROUND
The purpose of this study was to evaluate the use of the modified natural cycle (MNC) for IVF in poor responders as a last resort prior to oocyte donation.


METHODS
Thirty-two patients with a regular menstrual cycle, FSH levels on day 3 of the cycle >12 IU/l and one or more failed IVF cycles with five or fewer cumulus-oocyte complexes (COCs) retrieved were included in this prospective study. Recombinant FSH 100 IU and GnRH antagonist 0.25 mg/day were started concomitantly when a follicle with a mean diameter of 14 mm was present at ultrasound. HCG 10 000 IU was administered as soon as the mean follicular diameter was > or =16 mm.


RESULTS
Twenty-five out of 78 cycles performed (32.1%) did not result in oocyte retrieval. In nine out of 53 cycles (16.9%) in which oocyte retrieval was performed, no COCs were retrieved. Following fertilization, embryo transfer was performed in 19 out of 44 cycles in which COCs were retrieved (43.2%). No ongoing pregnancy was achieved in 78 MNCs (0.0%; 95% confidence interval 0.0-4.7).


CONCLUSIONS
MNC does not offer a realistic chance of parenthood in patients with high levels of FSH on day 3 of the cycle and previous poor response to ovarian stimulation, when offered as a last resort prior to oocyte donation.
Center for Reproductive Medicine, Dutch-Speaking Brussels Free University, Laarbeeklaan 101, B-1090, Brussels, Belgium. stratis@easynet.be
Efstratios
E
Kolibianakis
Kostantinos
K
Zikopoulos
Michel
M
Camus
Herman
H
Tournaye
André
A
Van Steirteghem
Paul
P
Devroey
D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood* / Q000494:pharmacology; D005498:Follicular Phase / Q000187:drug effects / Q000502:physiology; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000628:therapy*; D018587:Oocyte Donation; D009865:Oocytes / Q000187:drug effects / Q000502:physiology*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D017211:Treatment Failure; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone