title: How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one-and-done approach.
abstract: To study how many infertility patients would complete an average-sized family (achieve ≥2 live births) after a single, complete in vitro fertilization (IVF) cycle.
  
  
  
  A retrospective cohort study.
  
  
  
  University-affiliated private infertility practice.
  
  
  
  Women undergoing IVF.
  
  
  
  None.
  
  
  
  The outcome of 1 or ≥2 live births after a single retrieval cycle, followed by use of all embryos in subsequent frozen cycles in relation to oocyte number.
  
  
  
  The pregnancy rate was statistically significantly higher when ≥15 oocytes were retrieved (289 of 699, 41.3%) than <15 oocytes (518 of 1,419, 36.5%). When investigating the outcome of ≥2 live births and assuming that all remaining frozen embryos were used, we found that 498 of 2,226 (22.4%) patients would achieve ≥2 live births. We performed multivariate analysis, and the area under the receiver operating characteristic curve for the model was 0.802. When controlling for multiple factors we found that as the number of oocytes retrieved increased, the chance of at least two live births increased, with odds ratio 1.08 (8% live birth increase per additional oocyte).
  
  
  
  We demonstrate that one fresh cycle with high oocyte yield is an optimal way to plan IVF treatment. With modern cryopreservation methods, the concept of "one-and-done" could safely achieve ≥2 live births with just one stimulation cycle in almost a quarter of our patients.
authors.affiliation: Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Denis A
authors.initials: DA
authors.lastname: Vaughan
authors.affiliation: Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Angela
authors.initials: A
authors.lastname: Leung
authors.affiliation: Boston IVF, Waltham, Massachusetts; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Nina
authors.initials: N
authors.lastname: Resetkova
authors.affiliation: Research Design Center, Biostatistics Research Center, Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Robin
authors.initials: R
authors.lastname: Ruthazer
authors.affiliation: Boston IVF, Waltham, Massachusetts; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Penzias
authors.affiliation: Boston IVF, Waltham, Massachusetts. Electronic address: dsakkas@bostonivf.com.
authors.forename: Denny
authors.initials: D
authors.lastname: Sakkas
authors.affiliation: Boston IVF, Waltham, Massachusetts; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Alper
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015925:Cryopreservation; D004624:Embryo Transfer; D005191:Family Characteristics; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D050498:Live Birth; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D054315:Oocyte Retrieval / Q000009:adverse effects; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Family completion; IVF; live birth; ovarian hyperstimulation