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Optimum oocyte retrieved and transfer strategy in young women with normal ovarian reserve undergoing a long treatment protocol: a retrospective cohort study

  • Assisted Reproduction Technologies
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Abstract

Purpose

This study aimed to investigate the relationship between the number of oocytes retrieved and clinical outcomes in young women with normal ovarian reserve who were undergoing their first in vitro fertilization and embryo transfer (IVF-ET) cycle. The transfer strategy based on yielded oocytes was also discussed in this article.

Methods

A total of 1567 patients who underwent first long protocol of IVF treatment in our reproductive medical center between January 2010 and June 2014 were categorized into five groups based on the retrieved oocyte number, namely, 4∼6, 7∼9, 10∼12, 13∼15, and ≥16. Baseline parameters were similar among the groups. Primary outcome was defined as the cumulative live birth rate (CLBR), and secondary outcomes included the rate of patients with high risks for ovarian hyperstimulation syndrome (OHSS).

Results

It was found that the CLBR increased with the number of oocytes, as well as the rate for high risks of OHSS. In fresh cycles, 10∼12 oocyte group demonstrated the highest implantation rate (53.32 %), clinical pregnancy rate (CPR) (73.13 %), and live birth rate (LBR) (61.14 %), with no significant differences. Moreover, both cumulative CPR (CCPR) and CLBR became significantly higher in the 10∼12 oocyte group, compared with 4∼6 and 7∼9 groups. However, when the retrieved oocytes increased to 13∼15 or ≥16, the cumulative results did not have a significant increase. Also, the high risk rate of OHSS was much lower in the 10∼12 group (11.53 %) than that in the 13∼15 group (29.97 %) and ≥16 group (77.30 %). Unconditional multivariate logistic regression analysis showed that when ≥10 oocytes were retrieved, the CLBR increased significantly (P < 0.01). When oocyte number exceeded 16, the CPR of frozen embryo transfer cycle was much higher than that of fresh cycle (P < 0.05).

Conclusions

For young women with normal ovarian reserve, retrieving 10∼12 oocytes might result in optimized pregnancy outcomes in a fresh cycle with low OHSS risk and would not compromise cumulative outcomes. When ≥16 oocytes were retrieved, a “freeze-all” embryo strategy might be preferable.

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Acknowledgments

The authors thank everyone at the Reproductive Medical Center of Henan provincial People’s Hospital for their scientific advice and encouragement.

Conlfict of interest

The authors declare that they have no competing interests.

Author contributions

All authors made substantial contributions to the conception and design of this research study. C-yH and X-xH acquired and analyzed the data and wrote the manuscript. QW collected the data. Z-sD, J-lL, and G-zJ critically revised the manuscript. Z-cL finally approved the manuscript. All authors read and approved the final manuscript.

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Author notes

    Authors and Affiliations

    1. Reproductive Medical Center, People’s Hospital of Zhengzhou University, 450003, Weiwu Road, Zhengzhou, Henan Province, People’s Republic of China

      Yuan-hui Chen, Xiao-hang Xu, Qian Wang & Li-le Jiang

    2. Reproductive Medical Center, Henan Provincial People’s Hospital, 450003, Weiwu Road, Zhengzhou, Henan Province, People’s Republic of China

      Yuan-hui Chen, Xiao-hang Xu, Qian Wang, Shao-di Zhang, Li-le Jiang, Cui-lian Zhang & Zhao-jia Ge

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    1. Yuan-hui Chen
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    2. Xiao-hang Xu
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    5. Li-le Jiang
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    6. Cui-lian Zhang
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    7. Zhao-jia Ge
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    Correspondence to Cui-lian Zhang.

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    Capsule

    For young women with normal ovarian reserve, retrieving 10∼12 oocytes might result in optimized pregnancy outcomes in consideration of both fresh and frozen transfers. With more than 16 oocytes, a “freeze-all” embryo strategy might be preferable

    Yuan-hui Chen and Xiao-hang Xu contributed equally to this work.

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    Chen, Yh., Xu, Xh., Wang, Q. et al. Optimum oocyte retrieved and transfer strategy in young women with normal ovarian reserve undergoing a long treatment protocol: a retrospective cohort study. J Assist Reprod Genet 32, 1459–1467 (2015). https://doi.org/10.1007/s10815-015-0571-6

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    • DOI: https://doi.org/10.1007/s10815-015-0571-6

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