Natural-cycle in vitro fertilization in poor responder patients: a survey of 500 consecutive cycles

Objective

To determine the role of the natural cycle for in vitro fertilization (IVF) in poor responder patients.

Design

Retrospective survey.

Setting

Private center for assisted reproduction.

Patient(s)

294 women who were poor responders in a previous IVF cycle.

Intervention(s)

Analysis of 500 consecutive natural cycles IVF.

Main Outcome Measure(s)

Number of cycles with oocytes, pregnancy rate per cycle, per transfer, and implantation rate.

Result(s)

Oocytes were found in 391 cases (78.1%), and cleaving embryos suitable for transfer were obtained in 285 cycles (57.0%). Pregnancy was observed in 49 cases, with a pregnancy rate of 9.8% per cycle, 17.1% per transfer, and 16.7% per patient. The patients were subdivided arbitrarily by the women's age into three groups. Patients 35 years old or younger showed a pregnancy rate of 18.1% per cycle, 29.2% per transfer, and 31.7% per patient. Women aged between 36 and 39 years showed a pregnancy rate of 11.7% per cycle, 20.6% per transfer, and 20.3% per patient. Women 40 years old or older showed a pregnancy rate of 5.8% per cycle, 10.5% per transfer, and 9.7% per patient. No differences were found for any of the evaluated parameters, independent of which cycle was the first, the second, third, fourth, or fifth, or further consecutive cycle.

Conclusion(s)

In poor responder patients, natural-cycle IVF is an effective treatment, especially in younger women.

Key Words: Natural cycle, IVF, ICSI, poor responder, cumulative pregnancy rate