Oocyte retrieval timing based on spontaneous luteinizing hormone surge during natural cycle in vitro fertilization treatment

Objective: To determine the efficiency of oocyte retrieval ( OR) timing based on the occurrence of spontaneous LH surge during natural cycle IVF (ncIVF) treatment. Design: Retrospective cohort study. The cohort was divided into five subgroups according to the presumed stage of spontaneous LH surge on scheduling day (1A: before onset; 1B: surge start; 2: ascending slope; 3: peak; and 4: descending slope). Setting: Private infertility clinic. Patient(s): Three hundred sixty-five infertile patients who underwent 1,138 ncIVF treatment cycles during 2008-2011. Intervention(s): Drug-free ncIVF treatment. Main Outcome Measure(s): Rate of successfully retrieved, fertilized oocytes, cleaved embryos, and live births per scheduled oocyte retrieval. Result(s): In 61% of the cycles OR was scheduled before or just at the start of the LH surge (groups 1A-1B), whereas in the remaining cases it was scheduled after the surge had already started (groups 2-4). The proportion of cycles with successfully recovered (range, 71%-86%), inseminated (range, 61%-78%), fertilized oocytes (range, 47%-68%), cleaved embryos (range, 45%-66%), and live births (range, 4.1%-9.2%) was not significantly different among subgroups. Conclusion(s): In ncIVF treatment OR timing based on the occurrence of spontaneous LH surge is feasible, yielding acceptable oocyte recovery, fertilization, and embryo cleavage rates. This strategy combined with a rapid and lowrisk OR procedure permits the management of a large ncIVF program on a 7-days-per-week basis within working hours. (c) 2014 by American Society for Reproductive Medicine.