The Use of Minimal Ovarian Stimulation to Achieve Autologous Pregnancy in Extremely Poor Prognosis Patients [36T

Abstract

INTRODUCTION: Patients with extreme advanced reproductive age and/or markedly diminished ovarian reserve are often recommended to undergo oocyte donation following failure to obtain embryos or achieve pregnancy with conventional high dose ovarian stimulation protocols. We present a cohort of patients who were recommended to use oocyte donation who underwent minimal stimulation for the purposes of embryo banking subsequently achieving ongoing pregnancy. METHODS: Retrospective cohort. RESULTS: A total of 20 self-referred patients after only being offered donor oocyte at an outside fertility clinic. Characteristics of this cohort included mean age 40.1 ± 0.74 years, Anti-Müllerian hormone 0.89 ng/mL ± 0.19, and the average number of conventional high dose cycles prior to referral was 2.2 ± 0.3 cycles. Of the patients undergoing minimal ovarian stimulation protocols, 90% (18/20) were able to have embryos frozen after undergoing 3.8 (+/- 0.41) cycles. Of these patients, 61.1% (11/18) progressed to embryo transfer (ET). For those who underwent ET, a total of 5 ongoing pregnancies (45% pregnancy rate) were achieved with an average time to pregnancy of 1.3 ± 0.24 years. Two spontaneous pregnancies (1 ongoing and 1 miscarriage) occurred during the course of treatment. CONCLUSION: Repetitive minimal simulation protocols with embryo banking allow the opportunity for autologous pregnancy in patients who previously failed conventional stimulation protocols and were recommended donor oocytes.