Natural cycle in vitro fertilization-embryo transfer at the University of Ottawa: an inefficient therapy for tubal infertility

To describe our experience with natural cycle IVF making clinical and endocrine comparisons with our standard stimulated cycle IVF program. We attempted 75 natural IVF-ET cycles with hCG given to preempt the LH surge and compared these with 450 attempts at standard superovulation IVF-ET done in our...

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Bibliographic Details
Published in:Fertility and sterility 1993-08, Vol.60 (2), p.298-302
Main Authors: Claman, Paul, Domingo, Minerva, Garner, Peter, Leader, Arthur, Spence, John E.H.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Birth control
Embryo Transfer
Fallopian Tube Diseases - complications
Female
Fertilization in Vitro
Gonadal Steroid Hormones - blood
Gynecology. Andrology. Obstetrics
Humans
In vitro fertilization
Infertility, Female - blood
Infertility, Female - etiology
Infertility, Female - therapy
Medical sciences
Menstrual Cycle
natural cycle
Pregnancy
Reference Values
Sterility. Assisted procreation
Superovulation
unstimulated cycle
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Summary:To describe our experience with natural cycle IVF making clinical and endocrine comparisons with our standard stimulated cycle IVF program. We attempted 75 natural IVF-ET cycles with hCG given to preempt the LH surge and compared these with 450 attempts at standard superovulation IVF-ET done in our unit during the same time period. Natural cycle patients are normally ovulating women < age 38. Superovulation IVF-ET patients are all < 41 years old. Patients in both groups had partners with normal semen parameters and tubal factor infertility. Cancellation rates, pregnancy rates per egg retrieval, per ET procedure, and luteal phase E2:P ratios of the treatment cycles are compared. There were 35 of 75 (47%) natural cycle and 112 of 450 (25%) superovulation cycle cancellations. An egg was retrieved in only 24 of 40 (60%) natural cycles and 336 of 338 (99%) superovulation egg retrieval procedures. Pregnancy rates per ovum pick-up procedure were significantly higher: 65 of 338 (19%) in the superovulation versus 2 of 40 (5%) in the natural cycle groups. Pregnancy rates per ET were not significantly different between natural IVF-ET, 2 of 18 (11%) and superovulation IVF-ET, 65 of 298 (22%). The E2:P ratios 5 days after ET were similar in both groups at 18 ± 4 after natural IVF-ET and 21 ± 18 after superovulation IVF-ET. [1] Cancellation rates for natural cycle IVF are very high. [2] Midluteal E2:P ratios are the same in both groups. [3] Pregnancy rates per egg retrieval are significantly lower for natural versus superovulation IVF-ET. [4] In our experience natural cycle IVF-ET is an inefficient therapy for tubal infertility compared with superovulation IVF-ET.
ISSN:0015-0282
1556-5653
DOI:10.1016/S0015-0282(16)56101-9