Flexibility in starting ovarian stimulation at different phases of the menstrual cycle for treatment of infertile women with the use of in vitro fertilization or intracytoplasmic sperm injection.
OBJECTIVE
To investigate flexibility in starting controlled ovarian stimulation at any phase of the menstrual cycle in infertile women undergoing treatment with assisted reproduction.


METHODS
Retrospective cohort study.


METHODS
Academic tertiary-care medical center.


METHODS
At total of 150 infertile patients undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. Ninety of the women also underwent frozen embryo transfer (FET) procedures.


METHODS
Depending on the phase of the menstrual cycle when ovarian stimulation was started, three groups of patients were identified, namely: conventional group (ovarian stimulation started in the early follicular phase), late follicular phase group, and luteal phase group. When dominant follicles were observed, final oocyte maturation was triggered with the use of GnRH agonist and hCG. In all three groups, viable embryos were cryopreserved for subsequent transfer.


METHODS



METHODS
number of mature oocytes retrieved.


RESULTS
fertilization rate, viable embryo rate per oocyte retrieved, cancellation rate, and clinical pregnancy outcomes from FET cycles.


RESULTS
There were no differences in the mean number of mature oocytes retrieved in the conventional group, late follicular phase group, and luteal phase group (5.7 ± 3.6, 5.2 ± 3.7, and 5.2 ± 3.9, respectively). Similarly, no significant differences were observed in the viable embryo rate per oocyte retrieved (37.9%, 38.5%, and 43.6%), clinical pregnancy rates (41.5%, 45.5%, and 38.9%), and implantation rates (30.7%, 30.2%, and 27.1%) in the three groups.


CONCLUSIONS
All three ovarian stimulation protocols were observed to be equally effective. These results demonstrate that ovarian stimulation can be commenced on any day of the menstrual cycle.


BACKGROUND
ChiCTR-OPN-15007332.
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China; Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China.
Ningxin
N
Qin
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Qiuju
Q
Chen
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Qingqing
Q
Hong
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Renfei
R
Cai
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Hongyuan
H
Gao
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Yun
Y
Wang
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Lihua
L
Sun
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Shaozhen
S
Zhang
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Haiyan
H
Guo
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Yonglun
Y
Fu
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Ai
A
Ai
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Hui
H
Tian
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Qifeng
Q
Lyu
Newlife Fertility Centre, Mississauga, Ontario, Canada.
Salim
S
Daya
Department of Assisted Rreproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China. Electronic address: kuangyanp@126.com.
Yanping
Y
Kuang
D000328:Adult; D002681:China; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D015925:Cryopreservation; D004334:Drug Administration Schedule; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro / Q000009:adverse effects; D005498:Follicular Phase; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008183:Luteal Phase; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008596:Menotropins / Q000008:administration & dosage; D054315:Oocyte Retrieval; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D017258:Medroxyprogesterone Acetate
controlled ovarian stimulation; flexible start for ovarian stimulation; frozen embryo transfer