title: Accumulation of oocytes: a new strategy for managing low-responder patients.
abstract: Accumulation of oocytes from several ovarian stimulation cycles is currently possible using novel vitrification technologies. This strategy could increase the inseminated cohort, creating a similar situation to normoresponders. This study included 242 low-responder (LR) patients (594 cycles) whose mature oocytes were accumulated by vitrification and inseminated simultaneously (LR-Accu-Vit) and 482 patients (588 cycles) undergoing IVF/embryo transfer with fresh oocytes in each stimulation cycle (LR-fresh). Drop-out rate in the LR-fresh group was >75%. The embryo-transfer cancellation per patient was significantly lower in the LR-Accu-Vit group (9.1%) than the LR-fresh group (34.0%). Live-birth rate (LBR)/patient was higher in the LR-Accu-Vit group (30.2%) than the LR-fresh group (22.4%). Cumulative LBR/patient was statistically higher in the LR-Accu-Vit group (36.4%) than the LR-fresh group (23.7%) and a similar outcome was observed among patients aged ⩾40years (LR-Accu-Vit 15.8% versus LR-fresh 7.1%). The LR-Accu-Vit group had more cycles with embryo cryopreservation (LR-Accu-Vit 28.9% versus LR-fresh 8.7%). Accumulation of oocytes by vitrification and simultaneous insemination represents a successful alternative for LR patients, yielding comparable success rates to those in normoresponders and avoiding adverse effects of a low response. The accumulation of oocytes from several ovarian stimulation cycles is currently possible with the aid of novel vitrification technologies. This strategy could be useful for low-responder patients, contributing to increase the inseminated cohort and creating a similar situation as in normal responders. According to the results presented herein (higher live-birth rate per patient treated), this strategy represents a successful alternative for low-responder patients, yielding comparable success rates to those in normal responders and avoiding the adverse effects of a low response.
authors.affiliation: Instituto Valenciano de Infertilidad, Cryo-biology Unit, IVF Laboratory, Valencia, Spain. acobo@ivi.es
authors.forename: A
authors.initials: A
authors.lastname: Cobo
authors.forename: Nicolás
authors.initials: N
authors.lastname: Garrido
authors.forename: Juana
authors.initials: J
authors.lastname: Crespo
authors.forename: Remohí
authors.initials: R
authors.lastname: José
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellicer
mesh_terms: D000328:Adult; D004526:Efficiency; D019924:Embryo Disposition; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000175:diagnosis / Q000628:therapy*; D054315:Oocyte Retrieval / Q000379:methods; D009865:Oocytes; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D014021:Tissue Preservation / Q000379:methods*; D017211:Treatment Failure; D058989:Vitrification