title: In vitro fertilization and embryo transfer in seminatural cycles for patients with ovarian aging.
abstract: OBJECTIVE
  To investigate whether seminatural cycle is a reasonable management for ovarian aging patients.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  ART Unit, Clamart, France.
  
  
  METHODS
  Seventy-five women, 158 cycles.
  
  
  METHODS
  Infertile women who presented with ovarian aging (defined as low ovarian reserve and characterized by cycle day 3 high FSH, high E2, and/or low inhibin B and/or previous cycle cancellations due to poor ovarian response to COH) were studied. Patients were offered up to three cycles. Treatment was scheduled as follows. From cycle day 8 onward the selection of the dominant follicle was monitored by ultrasound and hormonal measurements. When the dominant follicle appeared, patients received GnRH antagonist and, thereafter, hMG to support further follicular development.
  
  
  METHODS
  Implantation rate and clinical pregnancy.
  
  
  RESULTS
  Twenty-eight of 158 cycles were cancelled (17.7%). Oocyte pickups were performed in 119 (75.3%) cycles, 91 (57.6%) mature oocytes were retrieved, and 67 (42.4%) embryos transferred. Nineteen clinical pregnancies were obtained; the cumulative pregnancy rate per patient, after 3 cycles, was 35.2%.
  
  
  CONCLUSIONS
  Use of a seminatural cycle is a reasonable management for patients with ovarian aging who have ovulatory menstrual cycles. It achieves a high implantation rate (28.3%).
authors.affiliation: Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart, France.
authors.forename: Altina
authors.initials: A
authors.lastname: Castelo Branco
authors.forename: Nelly
authors.initials: N
authors.lastname: Achour-Frydman
authors.forename: Jacques
authors.initials: J
authors.lastname: Kadoch
authors.forename: Renato
authors.initials: R
authors.lastname: Fanchin
authors.forename: Gerard
authors.initials: G
authors.lastname: Tachdjian
authors.forename: René
authors.initials: R
authors.lastname: Frydman
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005498:Follicular Phase / Q000502:physiology*; D006801:Humans; D010053:Ovary / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies