Table 3.
IVM cycle characteristics and results in patients with resistant ovary syndrome
| Resistant ovary syndrome | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient No. | Baseline serum FSH (IU/L) | Protocol | Hormonal pretreatment | Days of stimulation | Maturation trigger | Serum E2 on oocyte retrieval day (ng/L) | COC | MII after IVM | D3 embryo | Embryo utilization rate | Fresh ET/FET (SET/DET) | Result |
| 1 | 11.5 | B | HRT | NA | No | 361 | 3 | 0 | 0 | NA | NA | No mature oocytes |
| 8.6 | B | HRT | NA | No | 288 | 3 | 0 | 0 | NA | NA | No mature oocytes | |
| 2 | 0.4 | D | HP-hMG 300 IU/day | 4 | No | 55 | 4 | 2 | 1 | 1/1 | NA | One embryo cryopreserved |
| 3 | 23 | B | HRT | NA | No | 308 | 0 | 0 | 0 | NA | NA | No oocytes |
| 26.4 | C | No | NA | No | 258 | 3 | 0 | 0 | NA | NA | No mature oocytes | |
| 4 | 9.4 | D | HP-hMG 150 IU/day | 9 | 10,000 IU uhCG | U | 5 | 5 | 1 | 1/3 | Fresh ET (SET) | Not pregnant |
| 5 | 29.3 | B | HRT | NA | No | 98 | 19 | 2 | 0 | NA | NA | No fertilization |
| 46.6 | C | No | NA | No | 44 | 28 | 1 | 1 | 1/1 | FET (SET) | First trimester miscarriage | |
| 6 | 18.3 | C | No | NA | No | 15 | 21 | 11 | 8 | 8/10 | FET** | Not pregnant** |
| 7 | 27.7 | B | HRT | NA | No | 226 | 3 | 0 | 0 | NA | NA | No mature oocytes |
| 27.7 | C | No | NA | No | 49 | 33 | 4 | 1 | 1/3 | FET (SET) | Liveborn*** | |
| 8 | 6.5 | D | rFSH 200 IU/day | 11 | 10,000 IU uhCG | 32 | 12 | 10 | 2 | 2/10 | Fresh ET (DET) | Not pregnant |
| 8.6 | D | HP-hMG 150 IU/day | 10 | No | 58 | 8 | 6 | 0 | 0/6 | NA | 6 oocytes fertilized, poor-quality embryos | |
| 9 | D | rFSH 250 IU/day | 9 | No | 28 | 2 | 2 | 1 | 1/1 | FET (SET) | Not pregnant | |
| 5.2 | D | HP-hMG 300 IU/day | 5 | No | 21 | 5 | 4 | 1 | 1/2 | NA | 2 oocytes fertilized, 1 embryo cryopreserved, but no survival after warming | |
| 12 | D | HP-hMG 150 IU/day | 3 | No | 28 | 5 | 5 | 0 | 0/1 | NA | 1 oocyte fertilized, poor-quality embryo | |
| 12.6 | D | HP-hMG 150 IU/day | 4 | No | 21 | 11 | 5 | 2 | 2/2 | NA | 2 embryos cryopreserved, but no survival after warming | |
| 7.9 | D | HP-hMG 150 IU/day | 5 | 10,000 IU uhCG | 666 | 7 | 3 | 2 | 2/2 | Fresh ET (DET) | Liveborn | |
| 9 | 59.5 | C | No | NA | No | 243 | 6 | 0 | 0 | NA | NA | No mature oocytes |
| 49.1 | A | Grynberg protocol* | NA | 10,000 IU uhCG | 63 | 14 | 3 | 3 | 3/3 | Fresh ET (SET) + FET (SET) | Liveborn after fresh SET. Biochemical pregnancy after FET. Not pregnant after 2nd FET | |
| 85.5 | C | No | NA | No | U | 30 | 3 | 2 | 2/3 | FET (SET) | Biochemical pregnancy after FET. Not pregnant after 2nd FET | |
| 58.1 | C | No | NA | No | 5 | 35 | 9 | 3 | 3/3 | FET (SET) | First trimester miscarriage after FET. Remaining embryos: no survival after warming | |
| 71.1 | C | No | NA | No | 5 | 14 | 4 | 0 | NA | NA | No fertilization | |
| 61.5 | C | No | NA | No | 6 | 5 | 3 | 2 | 2/2 | FET (SET) | MCDA twin pregnancy after FET. Premature live birth of healthy twins at 31 weeks (placental abruption). One embryo cryopreserved | |
COC, cumulus-oocyte complexes; Embryo utilization rate, number of good-quality embryos transferred or cryopreserved per number of fertilized oocytes; HRT, hormone replacement therapy; HP-hMG, highly purified human menotropin; IU, international units; MCDA, monochorionic diamniotic; MII, mature oocytes; NA, not applicable; rFSH, recombinant FSH; SET, single embryo transfer; DET, double embryo transfer; U, unknown; uhCG, urinary hCG
*Grynberg protocol = oral tablets of 17-beta-estradiol, followed by a bolus of 10,000 IU hCG as soon as the endometrium thickness was deemed adequate (Grynberg et al. 2013)
**Four FET (SET) cycles followed by two FET (DET) cycles
***Oocyte donation within a lesbian relationship, FSH resistance in oocyte donor