4.6 Article

Correlation of IVF outcomes and number of oocytes retrieved: a UK retrospective longitudinal observational study of 172 341 non-donor cycles

Journal

BMJ OPEN
Volume 13, Issue 1, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2022-064711

Keywords

reproductive medicine; public health; health & safety; health economics; health policy

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This study found that the number of oocytes retrieved per IVF cycle has an impact on the live birth rate and multiple gestation pregnancy rates. There was limited benefit in live birth rate beyond the 6-15 oocyte group, and the risk of multiple gestation pregnancy was lower in the 1-5 oocyte group.
Objective How do numbers of oocytes retrieved per In vitro fertilisation (IVF) cycle impact on the live birth rate (LBR) and multiple gestation pregnancy (MGP) rates? Design Retrospective observational longitudinal study. Setting UK IVF clinics. Population Non-donor IVF patients. Main outcome measures LBR per IVF cycle and MGP levels against number of oocytes retrieved into subgroups: 0, 1-5, 6-15, 16-25, 26-49 oocytes and 50+ oocytes. Relative risk (RR) and 95% CIs were calculated for each group against the intermediate responder with '6-15 oocytes collected'. Results From 172 341 attempted fresh oocyte retrieval cycles, the oocyte retrieved was: 0 in 10 148 (5.9%) cycles from 9439 patients; 1-5 oocytes in 42574 cycles (24.7%); 6-15 oocytes in 91797 cycles (53.3%); 16-25 oocytes in 23794 cycles (13.8%); 26-49 oocytes in 3970 cycles (2.3%); >= 50 oocytes in 58 cycles (0.033%). The LBRs for the 1-5, 6-15, 16-25 and 26-49 subgroups of oocytes retrieved were 17.2%, 32.4%, 35.3% and 18.7%, respectively. The RR (95%CI) of live birth in comparison to the intermediate group (6-15) for 1-5, 16-25 and 26-49 groups was 0.53 (0.52 to 0.54), 1.09 (1.07 to 1.11) and 0.58 (0.54 to 0.62), respectively. The corresponding MGP rates and RR were 9.2%, 11.0%, 11.4% and 11.3%, respectively and 0.83 (0.77 to 0.90), 1.04 (0.97 to 1.11) and 1.03 (0.84 to 1.26), respectively. Conclusion There was only limited benefit in LBR beyond the 6-15 oocyte group going to the 16-25 oocytes group, after which there was significant decline in LBR. The MGP risk was lower in 1-5 group.

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