Selection of patients for natural cycle in vitro fertilization combined with in vitro maturation of immature oocytes

Objective To determine a successful method of selecting patients for natural cycle IVF combined with in vitro maturation (IVM) of immature oocytes and to determine treatment efficacy. Design Retrospective analysis of IVF treatments. Setting Hospital IVF clinic. Patient(s) Women with infertility according to ovarian reserve and endocrine profile were selected for different treatments. Interventions(s) According to screening criteria, infertile women were divided into three treatments: [1] natural cycle IVF combined with IVM (IVF/M), [2] IVM alone, and [3] controlled ovarian hyperstimulation (COH) with gonadotropin. Main Outcome Measure(s) The distribution of completed IVF–ET cycles in each treatment; clinical pregnancy and implantation rates in each treatment. Result(s) A total of 417 cycles were started, and 410 cycles (98.3%) were completed. Of 410 cycles, 151 (36.8%) were treated by natural cycle IVF/M, 63 (15.4%) underwent IVM alone, and 196 (47.8%) underwent COH. With increasing age fewer cycles can be treated by natural cycle IVF/M or IVM. Clinical pregnancy rates were 40.4% (61 of 151) for natural cycle IVF/M, 41.3% (26 of 63) for IVM alone, and 37.8% (74 of 196) for COH. There were no differences in implantation rate in the three groups (17.8% [82 of 462], 16.7% [35 of 210], and 20.1% [103 of 513]). Conclusion(s) Natural cycle IVF/M together with IVM-alone treatment can offer more than 50% of infertile women with an acceptable pregnancy and implantations rates.