Conventional ovarian stimulation and single embryo transfer for IVF/ICSI. How many oocytes do we need to maximize cumulative live birth rates after utilization of all fresh and frozen embryos?

@article{Drakopoulos2016ConventionalOS,
  title={Conventional ovarian stimulation and single embryo transfer for IVF/ICSI. How many oocytes do we need to maximize cumulative live birth rates after utilization of all fresh and frozen embryos?},
  author={P. Drakopoulos and C. Blockeel and D. Stoop and M. Camus and M. De Vos and H. Tournaye and N. Polyzos},
  journal={Human reproduction},
  year={2016},
  volume={31 2},
  pages={
          370-6
        }
}
STUDY QUESTION What is the impact of ovarian response on cumulative live birth rates (LBR) following utilization of all fresh and frozen embryos in women undergoing their first ovarian stimulation cycle, planned to undergo single embryo transfer (SET). SUMMARY ANSWER Cumulative LBR significantly increases with the number of oocytes retrieved. WHAT IS KNOWN ALREADY Several studies have addressed the issue of the optimal number of oocytes retrieved following controlled ovarian stimulation… Expand
Oocyte or embryo number needed to optimize live birth and cumulative live birth rates in mild stimulation IVF cycles.
TLDR
Nine oocytes, or four embryos, can optimize fresh transfer cycle LBR in MS-IVF while safeguarding against OHSS, retrospective analysis of a 4-year database of five fertility centres suggests. Expand
Cumulative live birth rates according to the number of oocytes retrieved after the first ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a multicenter multinational analysis including ∼15,000 women.
TLDR
The significant progressive increase of cumulative live birth rate with the number of oocytes in the study suggests that ovarian stimulation may not have a detrimental effect on oocyte/embryo quality in good-prognosis women less than 40 year old. Expand
How many oocytes or embryos are required to optimise live birth rate and cumulative live birth rate in mild stimulation in-vitro fertilisation cycles?
ABSTRACT Research question: How many oocytes or embryos are needed to optimise the livebirth rate (LBR) per-cycle and cumulative LBR (CLBR) following mild stimulation IVF (MS-IVF) in women withExpand
Cumulative live birth rates in in-vitro fertilization.
TLDR
Reporting IVF outcomes using cumulative live birth rates (LBR), defined as the first live birth following the use of all fresh and frozen embryos derived from a single ovarian stimulation cycle appears to be a better measure of IVF treatment success. Expand
The number of oocytes associated with maximum cumulative live birth rates per aspiration depends on female age: a population study of 221 221 treatment cycles.
TLDR
The results from the multivariable regression analysis showed that the number of oocytes retrieved remained a significant predictor of cumulative live birth per aspiration after adjusting for female age, parity and cycle count, and the rate of increase in CLBR per additional oocyte retrieved was lower in the older age groups. Expand
How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one-and-done approach.
TLDR
It is demonstrated that one fresh cycle with high oocyte yield is an optimal way to plan IVF treatment and with modern cryopreservation methods, the concept of "one-and-done" could safely achieve ≥2 live births with just one stimulation cycle in almost a quarter of patients. Expand
Freezing of all embryos in in vitro fertilization is beneficial in high responders, but not intermediate and low responders: an analysis of 82,935 cycles from the Society for Assisted Reproductive Technology registry.
TLDR
A freeze-all strategy is beneficial in high responders but not in intermediate or low responders, thus refuting the idea that freeze- all cycles are preferable for all patients. Expand
Fresh and cumulative live birth rates in mild versus conventional stimulation for IVF cycles in poor ovarian responders: a systematic review and meta-analysis
TLDR
Mild ovarian stimulation results in comparable outcomes to those of conventional stimulation in poor ovarian response patients with low ovarian reserve, and the possible benefit of a higher oocyte yield which may also improve prognosis in patients withpoor ovarian response is shown. Expand
Impact of elective frozen vs. fresh embryo transfer strategies on cumulative live birth: Do deleterious effects still exist in normal & hyper responders?
TLDR
Compared with a fresh-transfer strategy, the e-FET strategy resulted in a higher CLBR among patients with >10 oocytes retrieved during stimulated cycles, and birth weights were significantly lower for fresh ET, 3064 versus 3201 g for singletons (p<0.001) and perinatal and obstetrical outcomes were nonsignificantly different between fresh and e- FET arms. Expand
In Freeze-All Strategy, Cumulative Live Birth Rate (CLBR) Is Increasing According to the Number of Blastocysts Formed in Women <40 Undergoing Intracytoplasmic Sperm Injection (ICSI)
TLDR
A higher number of vitrified blastocysts is associated with higher CLBR in women <40 years old- normal/high responders- following Freeze- all policy, and adopting Freeze-all strategy after blastocyst culture can contribute to improve delivery outcome after IVF, in terms of CLBR. Expand
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TLDR
The concept of an optimal range of oocytes obtained in response to ovarian stimulation for IVF, below and above which outcomes are compromised, is supported. Expand
A high number of oocytes obtained after ovarian hyperstimulation for in vitro fertilization or intracytoplasmic sperm injection is not associated with decreased pregnancy outcome.
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Oocytes from high responders contain a greater fraction of immature oocytes, but pregnancy outcome is not impaired, according to multivariate logistic regression. Expand
Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes.
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There is insufficient evidence to recommend any one particular protocol for endometrial preparation over another with regard to pregnancy rates after embryo transfers, and there is evidence of a lower pregnancy rate and a higher cycle cancellation rate when the progesterone supplementation is commenced prior to oocyte retrieval in oocyte donation cycles. Expand
Correlation Between Number of Retrieved Oocytes and Pregnancy Rate After In Vitro Fertilization/IntraCytoplasmic Sperm Infection
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The study results clearly demonstrate that the aspiration of less than 5 oocytes significantly reduced pregnancy rate, and a large number of oocytes does not lead to an increase of the treatment effect and, at the same time, increases the risk of ovarian hyperstimulation syndrome. Expand
Association of number of retrieved oocytes with live birth rate and birth weight: an analysis of 231,815 cycles of in vitro fertilization.
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A higher number of retrieved oocytes was associated with an increased incidence of LBW in autologous singleton pregnancies resulting from transfer of two embryos, but not in donor oocyte cycles. Expand
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TLDR
The data suggest that in IVF cycles stimulated with a long protocol, the optimal number of oocytes for achieving a live birth is somewhere between 6 and 15, and the balance between maximum treatment success and minimum risk of complications, especially OHSS, should be further investigated. Expand
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There is insufficient evidence to support the use of one intervention in preference to another in assisted reproductive technology (ART), and moderate differences in either direction remain possible. Expand
Can you ever collect too many oocytes?
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It is suggested that you cannot collect too many oocytes as both clinical pregnancy and live birth rates do not decrease with high numbers of oocytes collected, however, once >15 oocytes are collected, everything gets quite uncertain. Expand
Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo: a randomized controlled trial.
TLDR
Differences in rates of mosaic embryos suggest an effect of ovarian stimulation on mitotic segregation errors, and future ovarian stimulation strategies should avoid maximizing oocyte yield, but aim at generating a sufficient number of chromosomally normal embryos by reduced interference with ovarian physiology. Expand
Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles.
TLDR
The relationship between the number of eggs and live birth, across all female age groups, suggests that the numberof eggs in IVF is a robust surrogate outcome for clinical success. Expand
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