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• W1969191736 abstract "ObjectiveOocyte retrieval (OR) scheduling is one of the main challenges of a completely drug-free nIVF protocol because it has to be based on precise estimation of the start of spontaneous LH surge.DesignRetrospective cohort study.Materials and Methods1138 consecutive nIVF cycles with monofollicular development performed by 506 patients were evaluated (2009-11). 63% of included patients were ≥40 years old (range: 28-51). Monitoring started on day 8 and continued every 2 days until follicular maturation. No GnRH antagonist was used to block the LH surge, only NSAIDs were administered before OR to reduce the ovulation risk. The cohort was divided in 5 subgroups according to the stage of spontaneous LH surge: before its start, early, late ascending slope, peak, descending slope. Final oocyte maturation was induced with nasal GnRH agonist in the earlier stages of LH surge. US-guided OR was performed without anaesthesia with a thin 22G needle allowing a rapid turnover of procedures. Outcome measures were the rate of cycles with successful oocyte recovery and successful fertilization.ResultsIn 61% of the cycles OR was scheduled before or just at the start of the LH surge whereas in the remaining cases it was scheduled after LH surge has already started. Most of the procedures (76%) could be performed in a 2-hour interval between 8-10 AM, whereas the remaining ones were finished until 5PM. Overall premature ovulation and successful oocyte recovery rates were 4% (45/1138) and 78% (886/1138). There were no significant differences in the proportion of cycles with successfully recovered (76, 84, 71, 88 and 67%, P=0.66) or fertilized oocytes (55, 64, 47, 68 and 67%, P=0.1) between subgroups 1 to 5, respectively.ConclusionIn natural cycle IVF treatment OR scheduling based on the occurrence of spontaneous LH surge yields acceptable oocyte recovery and fertilization rates. This strategy combined with a rapid and low-risk OR procedure permits the management of a large nIVF program within working hours on a 7-days week basis. ObjectiveOocyte retrieval (OR) scheduling is one of the main challenges of a completely drug-free nIVF protocol because it has to be based on precise estimation of the start of spontaneous LH surge. Oocyte retrieval (OR) scheduling is one of the main challenges of a completely drug-free nIVF protocol because it has to be based on precise estimation of the start of spontaneous LH surge. DesignRetrospective cohort study. Retrospective cohort study. Materials and Methods1138 consecutive nIVF cycles with monofollicular development performed by 506 patients were evaluated (2009-11). 63% of included patients were ≥40 years old (range: 28-51). Monitoring started on day 8 and continued every 2 days until follicular maturation. No GnRH antagonist was used to block the LH surge, only NSAIDs were administered before OR to reduce the ovulation risk. The cohort was divided in 5 subgroups according to the stage of spontaneous LH surge: before its start, early, late ascending slope, peak, descending slope. Final oocyte maturation was induced with nasal GnRH agonist in the earlier stages of LH surge. US-guided OR was performed without anaesthesia with a thin 22G needle allowing a rapid turnover of procedures. Outcome measures were the rate of cycles with successful oocyte recovery and successful fertilization. 1138 consecutive nIVF cycles with monofollicular development performed by 506 patients were evaluated (2009-11). 63% of included patients were ≥40 years old (range: 28-51). Monitoring started on day 8 and continued every 2 days until follicular maturation. No GnRH antagonist was used to block the LH surge, only NSAIDs were administered before OR to reduce the ovulation risk. The cohort was divided in 5 subgroups according to the stage of spontaneous LH surge: before its start, early, late ascending slope, peak, descending slope. Final oocyte maturation was induced with nasal GnRH agonist in the earlier stages of LH surge. US-guided OR was performed without anaesthesia with a thin 22G needle allowing a rapid turnover of procedures. Outcome measures were the rate of cycles with successful oocyte recovery and successful fertilization. ResultsIn 61% of the cycles OR was scheduled before or just at the start of the LH surge whereas in the remaining cases it was scheduled after LH surge has already started. Most of the procedures (76%) could be performed in a 2-hour interval between 8-10 AM, whereas the remaining ones were finished until 5PM. Overall premature ovulation and successful oocyte recovery rates were 4% (45/1138) and 78% (886/1138). There were no significant differences in the proportion of cycles with successfully recovered (76, 84, 71, 88 and 67%, P=0.66) or fertilized oocytes (55, 64, 47, 68 and 67%, P=0.1) between subgroups 1 to 5, respectively. In 61% of the cycles OR was scheduled before or just at the start of the LH surge whereas in the remaining cases it was scheduled after LH surge has already started. Most of the procedures (76%) could be performed in a 2-hour interval between 8-10 AM, whereas the remaining ones were finished until 5PM. Overall premature ovulation and successful oocyte recovery rates were 4% (45/1138) and 78% (886/1138). There were no significant differences in the proportion of cycles with successfully recovered (76, 84, 71, 88 and 67%, P=0.66) or fertilized oocytes (55, 64, 47, 68 and 67%, P=0.1) between subgroups 1 to 5, respectively. ConclusionIn natural cycle IVF treatment OR scheduling based on the occurrence of spontaneous LH surge yields acceptable oocyte recovery and fertilization rates. This strategy combined with a rapid and low-risk OR procedure permits the management of a large nIVF program within working hours on a 7-days week basis. In natural cycle IVF treatment OR scheduling based on the occurrence of spontaneous LH surge yields acceptable oocyte recovery and fertilization rates. This strategy combined with a rapid and low-risk OR procedure permits the management of a large nIVF program within working hours on a 7-days week basis." @default.
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• W1969191736 date "2012-09-01" @default.
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• W1969191736 title "Oocyte retrieval scheduling based on the occurrence of spontaneous LH surge during natural cycle IVF treatment: a retrospective analysis of 1138 cycles from a single center" @default.
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