How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one and done approach

With modern cryopreservation methods, maximizing the oocyte number could allow 22% of couples to safely achieve 2 live births with just one treatment cycle.

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Volume 107, Issue 2, Pages 397–404

Authors:

Denis A. Vaughan, M.D., Angela Leung, M.D., Nina Resetkova, M.D., Robin Ruthazer, M.P.H., Alan S. Penzias, M.D., Denny Sakkas, Ph.D., Michael M. Alper, M.D.

Abstract:

Objective

To study how many infertility patients would complete an average-sized family (achieve ≥2 live births) after a single, complete in vitro fertilization (IVF) cycle.

Design

A retrospective cohort study.

Setting

University-affiliated private infertility practice.

Patient(s)

Women undergoing IVF.

Intervention(s)

None.

Main Outcome Measure(s)

The outcome of 1 or ≥2 live births after a single retrieval cycle, followed by use of all embryos in subsequent frozen cycles in relation to oocyte number.

Result(s)

The pregnancy rate was statistically significantly higher when ≥15 oocytes were retrieved (289 of 699, 41.3%) than <15 oocytes (518 of 1,419, 36.5%). When investigating the outcome of ≥2 live births and assuming that all remaining frozen embryos were used, we found that 498 of 2,226 (22.4%) patients would achieve ≥2 live births. We performed multivariate analysis, and the area under the receiver operating characteristic curve for the model was 0.802. When controlling for multiple factors we found that as the number of oocytes retrieved increased, the chance of at least two live births increased, with odds ratio 1.08 (8% live birth increase per additional oocyte).

Conclusion(s)

We demonstrate that one fresh cycle with high oocyte yield is an optimal way to plan IVF treatment. 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 our patients.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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