Journal of Assisted Reproduction and Genetics

, Volume 34, Issue 4, pp 445–449 | Cite as

Outcome of gestational surrogacy according to IVF protocol

  • Ronit Machtinger
  • Nir-Ram Duvdevani
  • Oshrit Lebovitz
  • Jehoshua Dor
  • Ariel Hourvitz
  • Raoul Orvieto
Assisted Reproduction Technologies



Surrogacy remains the only option for having a biologic child for a unique population of women with severe medical conditions. However, no study has looked at surrogacy outcome as a result of the type of ovarian stimulation of the intended mother [controlled ovarian stimulation (COH), modified natural cycle (MNC), and in vitro maturation (IVM)] for oocyte retrieval.


This is a retrospective study, including all intended mothers and gestational carriers in a tertiary, university affiliated, medical center, from 1998 to 2016.


Fifty-two women underwent 252 oocyte retrieval cycles. The pregnancy outcome of 212 embryo transfer cycles (64 gestational carriers) was reviewed according to the origin of the embryo. The number of retrieved oocytes was significantly higher following COH (n = 132) compared with IVM (n = 58) and MNC cycles (n = 62) (p = 0.013 and p < 0.0001, respectively). Pregnancy rates for embryos transferred according to each protocol were similar. All pregnancies that ended in live births when oocytes from IVM cycles were used derived from transfers of retrieved mature and mixed mature and immature oocytes. Pregnancies that involved embryos derived solely from immature oocytes that further matured in vitro and were transferred to gestational carriers were unsuccessful.


MNC protocol is a good option to achieve pregnancy for intended mothers using gestational surrogacy who have contraindications to COH. The yield of IVM cycles in which immature oocytes are retrieved is inconclusive.


Gestational surrogate Intended mothers In vitro maturation Modified natural cycle 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.



Supplementary material

10815_2017_877_MOESM1_ESM.doc (30 kb)
Table S1 (DOC 29 kb)


  1. 1.
    Sills ES, Healy CM. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies. Reprod Health. 2008;5:9.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Utian WH, Sheean L, Goldfarb JM, Kiwi R. Successful pregnancy after in vitro fertilization and embryo transfer from an infertile woman to a surrogate. N Engl J Med. 1985;313(21):1351–2.PubMedGoogle Scholar
  3. 3.
    Brinsden PR. Gestational surrogacy. Hum Reprod Update. 2003;9(5):483–91.CrossRefPubMedGoogle Scholar
  4. 4.
    Brannstrom M, Johannesson L, Bokstrom H, Kvarnstrom N, Molne J, Dahm-Kahler P, et al. Livebirth after uterus transplantation. Lancet. 2015;385(9968):607–16.CrossRefPubMedGoogle Scholar
  5. 5.
    Balayla JEM, Dahdouh A, Lefkowitz G. Montreal Criteria for the Ethical Feasibility of Uterine Transplantation Research, Livebirth after uterus transplantation. Lancet. 2015;385(9985):2351–2.CrossRefPubMedGoogle Scholar
  6. 6.
    Guballa N, Sammaritano L, Schwartzman S, Buyon J, Lockshin MD. Ovulation induction and in vitro fertilization in systemic lupus erythematosus and antiphospholipid syndrome. Arthritis Rheum. 2000;43(3):550–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Anchan RM, Missmer SA, Correia KF, Ginsburg ES. Gestational carriers: a viable alternative for women with medical contraindications to pregnancy. Open J Obstet Gynecol. 2013;3(5B):24–31.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Raziel A, Schachter M, Strassburger D, Komarovsky D, Ron-El R, Friedler S. Eight years’ experience with an IVF surrogate gestational pregnancy programme. Reprod Biomed Online. 2005;11(2):254–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Dar S, Lazer T, Swanson S, Silverman J, Wasser C, Moskovtsev SI, et al. Assisted reproduction involving gestational surrogacy: an analysis of the medical, psychosocial and legal issues: experience from a large surrogacy program. Hum Reprod. 2015;30(2):345–52.CrossRefPubMedGoogle Scholar
  10. 10.
    Kedem A, Tsur A, Haas J, Yerushalmi GM, Hourvitz A, Machtinger R, et al. Is the modified natural in vitro fertilization cycle justified in patients with “genuine” poor response to controlled ovarian hyperstimulation? Fertil Steril. 2014;101(6):1624–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Leroy I, d’Acremont M, Brailly-Tabard S, Frydman R, de Mouzon J, Bouchard P. A single injection of a gonadotropin-releasing hormone (GnRH) antagonist (Cetrorelix) postpones the luteinizing hormone (LH) surge: further evidence for the role of GnRH during the LH surge. Fertil Steril. 1994;62(3):461–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Hourvitz A, Maman E, Brengauz M, Machtinger R, Dor J. In vitro maturation for patients with repeated in vitro fertilization failure due to “oocyte maturation abnormalities”. Fertil Steril. 2010;94(2):496–501.CrossRefPubMedGoogle Scholar
  13. 13.
    Son WY, Chung JT, Demirtas E, Holzer H, Sylvestre C, Buckett W, et al. Comparison of in-vitro maturation cycles with and without in-vivo matured oocytes retrieved. Reprod Biomed Online. 2008;17(1):59–67.CrossRefPubMedGoogle Scholar
  14. 14.
    Dahan MH, Tan SL, Chung J, Son WY. Clinical definition paper on in vitro maturation of human oocytes. Hum Reprod. 2016;31(7):1383–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Pelinck MJ, Hoek A, Simons AH, Heineman MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update. 2002;8(2):129–39.CrossRefPubMedGoogle Scholar
  16. 16.
    Schimberni M, Morgia F, Colabianchi J, Giallonardo A, Piscitelli C, Giannini P, et al. Natural-cycle in vitro fertilization in poor responder patients: a survey of 500 consecutive cycles. Fertil Steril. 2009;92(4):1297–301.CrossRefPubMedGoogle Scholar
  17. 17.
    Feldman B, Seidman DS, Levron J, Bider D, Shulman A, Shine S, et al. In vitro fertilization following natural cycles in poor responders. Gynecol Endocrinol: Off J Int Soc Gynecol Endocrinol. 2001;15(5):328–34.CrossRefGoogle Scholar
  18. 18.
    Chang EM, Song HS, Lee DR, Lee WS, Yoon TK. In vitro maturation of human oocytes: Its role in infertility treatment and new possibilities. Clin Exp Reprod Med. 2014;41(2):41–6.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Basatemur E, Sutcliffe A. Health of IVM children. J Assist Reprod Genet. 2011;28(6):489–93.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Suikkari AM. In-vitro maturation: its role in fertility treatment. Curr Opin Obstet Gynecol. 2008;20(3):242–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Coticchio G, Dal-Canto M, Guglielmo MC, Mignini-Renzini M, Fadini R. Human oocyte maturation in vitro. Int J Dev Biol. 2012;56(10-12):909–18.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Ronit Machtinger
    • 1
    • 2
  • Nir-Ram Duvdevani
    • 1
    • 2
  • Oshrit Lebovitz
    • 1
    • 2
  • Jehoshua Dor
    • 1
    • 2
  • Ariel Hourvitz
    • 1
    • 2
  • Raoul Orvieto
    • 1
    • 2
  1. 1.In Vitro Fertilization Unit, Department of Obstetrics and GynecologyChaim Sheba Medical CenterTel HashomerIsrael
  2. 2.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael

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