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In vitro fertilization following natural cycles in poor responders
B Feldman1, D S Seidman, J Levron
1In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Summary
Natural cycle in vitro fertilization (IVF) is feasible for poor responders, yielding results comparable to stimulated cycles. Early follicle-stimulating hormone (FSH) levels predict success within a cycle, but not for future attempts.
Area of Science:
- Reproductive Endocrinology
- In Vitro Fertilization
Background:
- Poor responders often face challenges with conventional stimulated in vitro fertilization (IVF) cycles.
- Natural cycle IVF offers a less invasive alternative, but its feasibility in poor responders requires examination.
Purpose of the Study:
- To assess the feasibility of natural cycle IVF in patients identified as poor responders.
- To identify clinical factors that may predict successful outcomes in natural cycle IVF for this patient group.
Main Methods:
- A prospective study involving 22 poor responders undergoing 44 natural cycle IVF treatments.
- Comparison of natural cycle outcomes with 55 previous low-response stimulated cycles from the same patients.
Main Results:
- 82% of patients had at least one oocyte retrieved, and 41% achieved embryo transfer.
- Two patients (9%) delivered healthy term babies, with outcomes comparable to stimulated cycles.
- Serum early follicular follicle-stimulating hormone (FSH) was the sole reliable predictor of oocyte recovery and outcome within a specific natural cycle.
Conclusions:
- Natural cycle IVF is a feasible treatment option for poor responders.
- While basal FSH levels can predict within-cycle success, their variability makes them unreliable for predicting future cycle outcomes.
- Poor responders may benefit from individualized natural cycle IVF approaches.