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Outcomes of 1503 cycles of modified natural cycle in vitro fertilization: a single-institution experience

  • Assisted Reproduction Technologies
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Abstract

Purpose

A retrospective cohort study was conducted in a single academic center to determine if modified natural cycle in vitro fertilization (mnIVF) is an acceptable treatment for the infertile couple.

Methods

Cycles performed between July 2005 and December 2011 were included. In our center’s mnIVF protocol, a GnRH antagonist, gonadotrophin, as well as Indocid are given on a daily basis from detection of a dominant follicle until ovulation induction. The primary outcomes were clinical pregnancy rates (CPR) per cycle started and per embryo transfer (ET). Outcomes were stratified by female patient age (≤35 years and ≥36 years). They were further stratified in each age group by ovarian response status according to the 2011 Bologna criteria.

Results

A total of 1503 cycles of mnIVF, performed in 782 patients, were analyzed. CPRs were 13.7 % per started cycle and 32.5 % per ET. Stratification by ovarian response status (normal or poor) in each age group showed similar CPRs in patients ≤35 years (p = 0.373), and divergent CPRs per ET in patients ≥36 years old (26.26 vs 6.25 %).

Conclusion

MnIVF is an acceptable treatment option for patients considering IVF, particularly for women ≤35 years old and for women ≥36 years old with normal ovarian response.

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References

  1. Fatemi HM, Popovic-Todorovic B, Humaidan P, Kol S, Banker M, Devroey P, et al. Severe ovarian hyperstimulation syndrome after gonadotropin-releasing hormone (GnRH) agonist trigger and “freeze-all” approach in GnRH antagonist protocol. Fertil Steril. 2014;101:1008–11.

    Article  CAS  PubMed  Google Scholar 

  2. Seyhan A, Ata B, Polat M, Son WY, Yarali H, Dahan MH. Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger with the addition of 1500 IU hCG. Hum Reprod. 2013;28:2522–8.

    Article  CAS  PubMed  Google Scholar 

  3. Humaidan P. Luteal phase rescue in high-risk OHSS patients by GnRHa triggering in combination with low-dose HCG: a pilot study. Reprod Biomed Online. 2009;18:630–4.

    Article  CAS  PubMed  Google Scholar 

  4. Pelinck MJ, Hoek A, Simons AHM, Heineman MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update. 2002;8(2):129–39.

    Article  CAS  PubMed  Google Scholar 

  5. Kettel LM, Roseff SJ, Chiu TC, Bangah ML, Vale W, Rivier J, et al. Follicular arrest during the midfollicular phase of the menstrual cycle: a gonadotrophin-releasing hormone antagonist imposed follicular-follicular transition. J Clin Endocrinol Metab. 1991;73(3):644–9.

    Article  CAS  PubMed  Google Scholar 

  6. Kadoch IJ, Al-Khaduri M, Phillips SJ, Lapensée L, Couturier B, Hemmings R, et al. Spontaneous ovulation rate before oocyte retrieval in modified natural IVF with and without indomethacin. Reprod Biomed Online. 2008;16(2):245–9.

    Article  PubMed  Google Scholar 

  7. Kawachiya S, Matsumoto T, Bodri D, Kato K, Takehara Y, Kato O. Short-term, low-dose, non-steroidal anti-inflammatory drug application diminishes premature ovulation in natural-cycle IVF. Reprod Biomed Online. 2012;24(3):308–13.

    Article  CAS  PubMed  Google Scholar 

  8. Rijken-Zijlstra TM, Haadsma ML, Hammer C, Burgerhof JGM, Pelinck MJ, Simons AHM, et al. Effectiveness of indometacin to prevent ovulation in modified natural cycle: a randomized controlled trial. Reprod Biomed Online. 2013;27:297–304.

    Article  CAS  PubMed  Google Scholar 

  9. Kadoch IJ, Phillips SJ, Bissonnette F. Modified natural-cycle in vitro fertilization should be considered as the first approach in young poor responders. Fertil Steril. 2011;96(5):1067–8.

    Article  Google Scholar 

  10. Vélez MP, Kadoch IJ, Phillips SJ, Bissonnette F. Rapid policy change to single-embryo transfer while maintaining pregnancy rates per initiated cycle. Redprod Biomed Online. 2013;26(5):506–11.

    Article  Google Scholar 

  11. Pelinck MJ, Vogel NEA, Hoek A, Simons AHM, Arts EGJM, Mochtar MH, et al. Cumulative pregnancy rates after three cycles of minimal stimulation IVF and results according to subfertility diagnosis: a multicentre cohort study. Hum Reprod. 2006;21(9):2375–83.

    Article  CAS  PubMed  Google Scholar 

  12. Bassil S, Godin PA, Donnez J. Outcome of in-vitro fertilization through natural cycles in poor responders. Hum Reprod. 1999;14:1262–5.

    Article  CAS  PubMed  Google Scholar 

  13. Castelo-Branco A, Frydman N, Kadoch J, Le Du A, Fernandez H, Fanchin R, et al. The role of the semi natural cycle as option of treatment of patients with a poor prognosis for successful in vitro fertilization. J Gynecol Obstet Biol Reprod. 2004;33:518–24.

    Article  CAS  Google Scholar 

  14. Matsuura T, Takehara Y, Kaijima H, Teramoto S, Kato O. Natural IVF cycles may be desirable for women with repeated failures by stimulated IVF cycles. J Assist Reprod Genet. 2008;25:162–7.

    Article  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. Morgia F, Sbracia M, Schimberni M, Giallonardo A, Piscitelli C, Gianni P, et al. A controlled trial of natural cycle versus microdose gonadotropin-releasing hormone analog flare cycles in poor responders undergoing in vitro fertilization. Fertil Steril. 2004;81(6):1542–7.

    Article  CAS  PubMed  Google Scholar 

  17. Ferraretti AP, La Marca A, Fauser BCJM, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26(7):1616–24.

    Article  CAS  PubMed  Google Scholar 

  18. Polyzos NP, Blockeel C, Verpoest W, De Vos M, Stoop D, Vloeberghs V, et al. Live birth rates following natural cycle IVF in women with poor ovarian response according to the Bologna criteria. Hum Reprod. 2012;27(12):3481–6.

    Article  CAS  PubMed  Google Scholar 

  19. Kedem A, Tsur A, Haas J, Yerushalmi GM, Hourvitzz 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.

    Article  PubMed  Google Scholar 

  20. Phillips SJ, Kadoch IJ, Lapensée L, Couturier B, Hemmings R, Bissonnette F. Controlled natural cycle IVF: experience in a world of stimulaton. Reprod Biomed Online. 2007;14(3):356–69.

    Article  PubMed  Google Scholar 

  21. Pelinck MJ, Vogel NE, Arts EG, Simons AH, Heineman MJ, Hoek A. Cumulative pregnancy rates after a maximum of nine cycles of modified natural cycle IVF and analysis of patient drop-out: a cohort study. Hum Reprod. 2007;22(9):2463–70.

    Article  CAS  PubMed  Google Scholar 

  22. Rongières-Bertrand C, Oliviennes F, Righini C, Franchin R, Taieb J, Hamamah S, et al. Revival of natural cycles in in-vitro fertilization with the use of a new gonadotrophin-releasing hormone antagonist (Cetrorelix): a pilot study with minimal stimulation. Hum Reprod. 1999;14(3):683–8.

    Article  PubMed  Google Scholar 

  23. Aanesen A, Pelinck MJ, Hoek A, Simons AHM, Heineman MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update. 2002;8(2):129–39.

    Article  Google Scholar 

  24. Gordon JD, DiMattina M, Reh A, Botes A, Celia G, Payson M. Utilization and success rates of unstimulated in vitro fertilization in the United States: an analysis of the Society for Assisted Reproductive Technology database. Fertil Steril. 2013;100(2):392–5.

    Article  PubMed  Google Scholar 

  25. Kato K, Takehara Y, Segawa T, Kawachiya S, Okuno T, Kobayash T, et al. Minimal ovarian stimulation combined with elective single embryo transfer policy: age-specific results of a large, single-centre Japanese cohort. Reprod Biol Endocrinol. 2012;10:35.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Reyftmann L, Déchaud H, Loup V, Anahory T, Brunet-Joyeux C, Lacroix N, et al. Natural cycle in vitro fertilization in poor responders. Gynecol Obstet Fertil. 2007;35:352–8.

    Article  CAS  PubMed  Google Scholar 

  27. Jamal W, Vélez MP, Zini A, Phillips S, Hemmings R, Kadoch IJ. Surgically retrieved spermatozoa versus ejaculated spermatozoa in modified natural IVF-ICSI cycles. Reprod Biomed Online. 2012;25:242–7.

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to acknowledge the work of the research staff for their implication in this study: Cecile LeSaint, Shirley Brugerie, Marie-Paule Lachambre, and Cynthia Levesque.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Funding and financial disclosure

None on behalf of all authors.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Obstetrics and Gynecology, University of Montreal Hospital Centre, 1058 Rue Saint-Denis, Montreal, QC, Canada, H2X 3J4

    Talya Shaulov, Maria P Vélez, Karen Buzaglo & Isaac Jacques Kadoch

  2. Clinique OVO, 8000 Boulevard Décarie, Montreal, QC, Canada, H4P 2S4

    Maria P Vélez, Karen Buzaglo, Simon J Phillips & Isaac Jacques Kadoch

Authors
  1. Talya Shaulov
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  2. Maria P Vélez
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  3. Karen Buzaglo
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  4. Simon J Phillips
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  5. Isaac Jacques Kadoch
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Corresponding author

Correspondence to Talya Shaulov.

Additional information

Capsule Modified natural IVF is a low-cost, patient-friendly treatment and is a reasonable option for infertile couples considering IVF, particularly for women ≤35 years old.

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Shaulov, T., Vélez, M.P., Buzaglo, K. et al. Outcomes of 1503 cycles of modified natural cycle in vitro fertilization: a single-institution experience. J Assist Reprod Genet 32, 1043–1048 (2015). https://doi.org/10.1007/s10815-015-0502-6

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  • DOI: https://doi.org/10.1007/s10815-015-0502-6

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