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. 017410 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 15 1) 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. (Fertil Steril (R) 2009;91:1050-5. (C) 2009 by American Society for Reproductive Medicine.)