Number of oocytes aspirated may be a powerful determinant of in vitro fertilization (IVF) ongoing pregnancies in all society for assisted reproductive technology (SART) age groups

Abstract

ObjectiveTo determine if a higher number of oocytes available at aspiration (oocyte yield) has a beneficial or detrimental effect on pregnancy outcome across all patient ages and if there exists an optimal oocyte number range for IVF success.DesignRetrospective analysis of consecutive IVF patient data.Materials and MethodsA total of 94 consecutive non-donor, non-pre-implantation genetic screening IVF patients underwent aspiration of all follicles greater than 8 mm followed by intra-cytoplasmic sperm injection of all mature oocytes, embryo culture and embryo transfer from January through August, 2013. Data for oocyte yield and live births or ongoing pregnancies were evaluated retrospectively according to each patient’s age using SART categories for IVF success rates in the Clinic Summary Report.ResultsLive birth/ongoing pregnancy rate for all patients under 43 years of age was 59%. Four groups representing number of oocytes collected in each case (0-5, 6-12, 13-19, 20 and above) yielded an ongoing pregnancy rate of 30, 80, 53 and 36%, respectively. Combining SART age categories (less than 35, 35-37, 38-40, 41-42) and number of oocytes collected demonstrated that 6-12 oocytes resulted in the highest pregnancy rate for every age category (77,79,80 and 100%, respectively) and that pregnancies declined as the number of oocytes recovered increased.ConclusionThese initial data are highly suggestive that ovarian stimulation and resulting oocyte numbers directly impact IVF success rate and that a clinical goal of obtaining higher oocyte yields may be counter-productive. ObjectiveTo determine if a higher number of oocytes available at aspiration (oocyte yield) has a beneficial or detrimental effect on pregnancy outcome across all patient ages and if there exists an optimal oocyte number range for IVF success. To determine if a higher number of oocytes available at aspiration (oocyte yield) has a beneficial or detrimental effect on pregnancy outcome across all patient ages and if there exists an optimal oocyte number range for IVF success. DesignRetrospective analysis of consecutive IVF patient data. Retrospective analysis of consecutive IVF patient data. Materials and MethodsA total of 94 consecutive non-donor, non-pre-implantation genetic screening IVF patients underwent aspiration of all follicles greater than 8 mm followed by intra-cytoplasmic sperm injection of all mature oocytes, embryo culture and embryo transfer from January through August, 2013. Data for oocyte yield and live births or ongoing pregnancies were evaluated retrospectively according to each patient’s age using SART categories for IVF success rates in the Clinic Summary Report. A total of 94 consecutive non-donor, non-pre-implantation genetic screening IVF patients underwent aspiration of all follicles greater than 8 mm followed by intra-cytoplasmic sperm injection of all mature oocytes, embryo culture and embryo transfer from January through August, 2013. Data for oocyte yield and live births or ongoing pregnancies were evaluated retrospectively according to each patient’s age using SART categories for IVF success rates in the Clinic Summary Report. ResultsLive birth/ongoing pregnancy rate for all patients under 43 years of age was 59%. Four groups representing number of oocytes collected in each case (0-5, 6-12, 13-19, 20 and above) yielded an ongoing pregnancy rate of 30, 80, 53 and 36%, respectively. Combining SART age categories (less than 35, 35-37, 38-40, 41-42) and number of oocytes collected demonstrated that 6-12 oocytes resulted in the highest pregnancy rate for every age category (77,79,80 and 100%, respectively) and that pregnancies declined as the number of oocytes recovered increased. Live birth/ongoing pregnancy rate for all patients under 43 years of age was 59%. Four groups representing number of oocytes collected in each case (0-5, 6-12, 13-19, 20 and above) yielded an ongoing pregnancy rate of 30, 80, 53 and 36%, respectively. Combining SART age categories (less than 35, 35-37, 38-40, 41-42) and number of oocytes collected demonstrated that 6-12 oocytes resulted in the highest pregnancy rate for every age category (77,79,80 and 100%, respectively) and that pregnancies declined as the number of oocytes recovered increased. ConclusionThese initial data are highly suggestive that ovarian stimulation and resulting oocyte numbers directly impact IVF success rate and that a clinical goal of obtaining higher oocyte yields may be counter-productive. These initial data are highly suggestive that ovarian stimulation and resulting oocyte numbers directly impact IVF success rate and that a clinical goal of obtaining higher oocyte yields may be counter-productive.