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Cumulative pregnancy rates after a maximum of nine cycles of modified natural cycle IVF and analysis of patient drop-out: a cohort study.
Pelinck, M J; Vogel, N E A; Arts, E G J M; Simons, A H M; Heineman, M J; Hoek, A.
Afiliação
  • Pelinck MJ; Section of Reproductive Medicine, Department of Obstetrics and Gynaecology, University Medical Center Groningen, Groningen, The Netherlands. pelinck@hotmail.com
Hum Reprod ; 22(9): 2463-70, 2007 Sep.
Article em En | MEDLINE | ID: mdl-17586833
BACKGROUND: In modified natural cycle IVF (MNV-IVF), treatment is aimed at using the one follicle that spontaneously develops to dominance, using a GnRH antagonist together with gonadotrophins in the late follicular phase only. METHODS: In this single-centre cohort study, nine cycles of MNV-IVF were offered to 268 patients. Cumulative pregnancy rates (CPRs) were calculated and drop-out was analysed. The present study is an extension of earlier studies in which three cycles of MNV-IVF were offered to the same patients. RESULTS: A total of 256 patients completed 1048 cycles (4.1 per patient). Embryo transfer rate was 36.5% per started cycle. Ongoing pregnancy rate was 7.9% per started cycle and 20.7% per embryo transfer. Including treatment-independent pregnancies, the observed CPR after up to nine cycles was 44.4% (95% confidence interval 38.3-50.5) per patient. Pregnancy rates per started cycle did not decline in higher cycle numbers (overall 9.9%). Drop-out rates were high (overall 47.8%). We found that cancellation of oocyte retrieval, fertilization failure and failure to reach embryo transfer are repeating phenomena in subsequent cycles and furthermore that these events predispose for drop-out. CONCLUSIONS: CPR after nine cycles of MNV-IVF in this study was 44.4%. Pregnancy rate per cycle did not decline in higher cycle numbers, possibly due to selective drop-out of poor prognosis patients. Due to the low-risk and patient-friendly nature of the MNC protocol, it seems a feasible treatment option for patients requiring IVF.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pacientes Desistentes do Tratamento / Fertilização in vitro / Taxa de Gravidez / Infertilidade Feminina Tipo de estudo: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: Europa Idioma: En Revista: Hum Reprod Assunto da revista: MEDICINA REPRODUTIVA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Holanda
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pacientes Desistentes do Tratamento / Fertilização in vitro / Taxa de Gravidez / Infertilidade Feminina Tipo de estudo: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: Europa Idioma: En Revista: Hum Reprod Assunto da revista: MEDICINA REPRODUTIVA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Holanda