IVF Lite - A New Strategy for Managing Poor Ovarian Res-ponders


IVFLite - Background: Previous trials have shown that neither conventional IVF nor natural cycle IVF is an effective treatment option for poor ovarian responders. However, none of the trials has examined the efficacy of accumulating embryos with serial minimal stimulation cycles, vitrifying the resulting embryos and transferring them in a remote cycle (IVF Lite protocol). Women with poor ovarian reserves, who commonly do not respond to conventional stimulation protocols, are left with few options when planning a family. The current study was undertaken to evaluate the efficacy of serial minimal stimulation in vitro fertilization (msIVF) cycles with vitrification of embryos for treatment of poor ovarian responders (PORs) as compared to conventional IVF protocols.

Materials and Methods: This is a retrospective data analysis of PORs from June 2010 to November 2012. A total of 222 patients were included in the study. Ninety-seven patients underwent serial minimal stimulation cycles with verification and embryo banking (IVF Lite Group) and 125 patients underwent conventional controlled ovarian stimulation for IVF. The patients identified as PORs based on the Bologna criteria were included in the analysis. In the IVF Lite group, embryos were vitrified using Cryotec vitrfication protocol on Day 3. Once six embryos were banked with us, a frozen embryo transfer was planned. A maximum of 3 embryos were transferred. Main outcome measure was the clinical pregnancy rate defined as positive fetal heartbeat at 12 weeks of pregnancy.

Results: There was no significant difference in the number of meta phase II (MII) oocytes retrieved between the both groups. The difference in the number of gonadotropins units required to produce one MII oocyte between the two groups was statistically highly significant: 680.4 units for the IVF Lite group and 4956.2 units for the conventional IVF group. The IVF Lite group had a higher percentage of good grade embryos. In the IVF Lite group, each patient underwent an average of 2.96 cycles of embryo accumulation before planning a frozen embryo transfer. An average of 6.2 embryos were accumulated for each patient. The clinical pregnancy rate (CPR) per embryo transfer was higher in the IVF Lite group (27.81%) than the conventional IVF group (15.15%). The CPR per patient was much higher in the IVF Lite (48.45%) than the conventional IVF group (24.0%).

Conclusion: The results obtained in the current study demonstrate that the IVF Lite protocol consisting of ms-IVF, ACCU-VIT and rET is a very successful approach in treating poor responders. Very favorable rates of pregnancy can be achieved with IVF Lite protocol.

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