scholarly journals The relationship between cannabis use and IVF outcome—a cohort study

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Eden Har-Gil ◽  
Ayala Heled ◽  
Marjorie Dixon ◽  
Abdul Munaf Sultan Ahamed ◽  
Yaakov Bentov
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Implantation Rate ◽  
Fertilization Rate ◽  
Cannabis Use ◽  
Ongoing Pregnancy ◽  
Female Reproduction ◽  
Ongoing Pregnancy Rate ◽  
Ivf Outcomes ◽  
Significant Difference

Abstract Background The effects of cannabis use on male and female reproduction have been the focus of scientific research for decades. Although initial studies raised concerns, more recent studies were reassuring. Considering the recent legalization of recreational use of cannabis in Canada, we sought to analyze IVF outcomes among users and non-users in a single IVF center. Methods This is a retrospective cohort study from a single IVF center assessing IVF outcomes among male-female, non-donor IVF patients that are either cannabis users or non-users. We analyzed the ongoing pregnancy rate as well as oocyte yield, fertilization rate, peak serum estradiol, sperm, and embryo quality. We used the Mann-Whitney test, chi-square test, and Kruskal-Wallis tests where appropriate. Results Overall, the study included 722 patients of which 68 (9.4%) were cannabis users, most defined as light users. The results of the study show similar implantation rate (40.74% vs. 41.13%) and ongoing pregnancy rate (35.2% vs. 29.1%) between the users and non-users, respectively. No significant difference between users and non-users in any of the other analyzed outcomes could be detected. Conclusions The results may provide some reassurance for the lack of any demonstrable detrimental effects of cannabis consumption on IVF outcomes. This study was limited by its retrospective nature, self-reporting of cannabis use, and a small user sample size. A larger prospective study is needed to validate its findings.

scholarly journals CC-Human Menopausal Gonadotropin Combined with Growth Hormone in Mini-stimulation Protocol could Improve Clinical Outcome in Poor Ovarian Responders

2016 ◽  
Author(s):  
Arie A Polim ◽  
Ivan R Sini ◽  
Indra NC Anwar ◽  
Aryando Pradana ◽  
Kurniawati Kurniawati ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pregnancy Rate ◽  
Group Versus ◽  
Poor Responders ◽  
Human Menopausal Gonadotropin ◽  
Ongoing Pregnancy ◽  
Stimulation Protocol ◽  
Ongoing Pregnancy Rate ◽  
Significant Difference ◽  
Poor Ovarian Responders

Objective: To investigate the role of CC-highly purified Human Menopausal Gonadotropin (hpHMG) and Growth Hormone (GH) in mini-stimulation protocol to improve outcome in poor ovarian responders (POR). Method: All patients were given clomiphene citrate 150 mg from day 3 to day 7 of menstrual cycle followed by 150 IU hpHMG daily from day 8 until ovulation trigger. Two groups were observed where one group received GH and the other arm did not. In the GH group, 8 IU of GH were given from day 1 of stimulation until stimulation was stopped. GnRH antagonist was used to suppress ovulation. Result: Among 51 eligible women, 29 patients with GH and 22 patients without GH, no difference was observed in the number of oocytes retrieved (2.21 versus 2.64) and the number of embryos transferred (1.24 versus 1.68) in the GH group versus the group without GH, respectively. Total clinical pregnancy rate was 17.6%. No significant difference in pregnancy and ongoing pregnancy rate in both groups (17.2% versus 18.2%) and (13.8% versus 13.6%), respectively. In patients older than 40 years old, GH showed a 4-fold likelihood in producing top quality embryos (44.8% vs 13.6%, OR=3.6, p=0.05). Conclusion: CC-HMG regimen in mini-stimulation protocol is an effective option in poor responders. Additional GH in ministimulation program provided a higher number of top quality embryos in women older than 40 years old, although there were no difference in clinical or ongoing pregnancy rate. Keywords: CC-HMG, growth hormone, IVF, mini-stimulation protocol, poor ovarian responders

scholarly journals Q10 Co-enzyme Effect on Fetus Implantation in ART Cycles

2020 ◽  
Vol 8 (2) ◽  
pp. 17
Author(s):  
Aliyeh Ghasemzadeh ◽  
Samira Abdollahi Moghadam ◽  
Laya Farzadi ◽  
Mohammad Noori
Keyword(s):  
Pregnancy Rate ◽  
Coenzyme Q10 ◽  
Implantation Rate ◽  
Fertilization Rate ◽  
Small Sample ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Grade Ii

Background and Aim: Infertility is a common condition that affects many couples. Although current cutting-edge therapeutic methods have been found promising in this regard, their success still is not sufficiently high. Accordingly, researchers are working to develop new methods to augment the likelihood of successful results of Assisted Reproductive Technology (ART). Recently, coenzyme Q10 has been recognized an important and influential factor in the process of reproduction and some scarce studies have been along favorable results in this regard. This study aims to examine the effect of oral administration of coenzyme Q10 on embryo implantation in ART cycles. Methods and Materials: In this randomized, placebo-controlled clinical trial, a total of 128 infertile females who were candidates for ART were randomized in two groups receiving either a daily capsule of coenzyme Q10 by the commencement of gonadotropin through to pregnancy test result (case group, 64 patients), or placebo (control group, 64 patients). Finally, oocyte count, fertilization rate, embryo count, quality of embryos, transferred embryo count, implantation rate and pregnancy rate were compared between the two groups. Results: The mean age of the patients was 32.77±6.01 years (20-41) in the case group and 32.45±5.93 years (20-42) in the case group, with no significant difference between the two groups (p=0.77). In comparison between the case and control groups, in spite of better results in the case group, no significant difference was found in terms of oocyte count (10.47±7.16 and 9.38±7.52, respectively; p=0.40), fertilization rate (66.88±16.08 % and 66.73±21.50 %, respectively; p=0.96), embryo count (7.03±4.78 and 5.84±4.85, respectively; p=0.17), quality of embryos (71.9% grade I and 28.1% grade II in cases, 68.8% grade I and 31.3% grade II in controls; p=0.70) transferred embryo count (10.9% one, 56.3% two-three and 32.8% more than three in cases, 14% one, 56.3% two-three and 29.7% more than three in controls; p=0.84), implantation rate (8.39±12.73 % and 7.22±12.80 %, respectively; p=0.60), and pregnancy rate (34.4% and 26.6%, respectively; p=0.34). Conclusion: Although using coenzyme Q10, in comparison with placebo, was along with better results in terms of outcome variables of ART, the difference was statistically insignificant possibly because of a small sample size and short duration of the intervention.

scholarly journals The impact of post-warming culture duration on clinical outcomes of vitrified-warmed single blastocyst transfer cycles

2020 ◽  
Vol 47 (4) ◽  
pp. 312-318
Author(s):  
Ji Young Hwang ◽  
Jae Kyun Park ◽  
Tae Hyung Kim ◽  
Jin Hee Eum ◽  
HaengSeok Song ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Implantation Rate ◽  
Ongoing Pregnancy ◽  
Short Term ◽  
Ongoing Pregnancy Rate ◽  
Long Term Culture ◽  
Culture Duration ◽  
Short Term Culture

Objective: The objective of the study was to compare the effects of long-term and short-term embryo culture to assess whether there is a correlation between culture duration and clinical outcomes. Methods: Embryos were divided into two study groups depending on whether their post-warming culture period was long-term (20–24 hours) or short-term (2–4 hours). Embryo morphology was analyzed with a time-lapse monitoring device to estimate the appropriate timing and parameters for evaluating embryos with high implantation potency in both groups. Propensity score matching was performed to adjust the confounding factors across groups. The grades of embryos and blastoceles, morphokinetic parameters, implantation rate, and ongoing pregnancy rate were compared.Results: No significant differences were observed in the implantation rate or ongoing pregnancy rate between the two groups (56.3% vs. 67.9%, p=0.182; 47.3% vs. 53.6%, p=0.513). After warming, there were more expanded and hatching/hatched blastocysts in the long-term culture group than in the short-term culture group, but there was no significant between-group difference in embryo grade. Regarding pregnancy outcomes, the completion of re-expansion was faster in women who became pregnant than in those who did not for both culture durations (long-term: 2.19±0.63 vs. 4.11±0.81 hours, p=0.003; short-term: 1.17±0.29 vs. 1.94±0.76 hours, p=0.018, respectively). Conclusion: The outcomes of short-term culture and long-term culture were not significantly different in vitrified-warmed blastocyst transfer. Regardless of the post-warming culture time, the degree of blastocyst re-expansion 3–4 hours after warming is an important marker for embryo selection.

scholarly journals The Clinical Relevance of Luteal Phase Progesterone Support in True Natural Cycle Cryopreserved Blastocyst Stage Embryo Transfers: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Ian Waldman ◽  
Catherine Racowsky ◽  
Emily Disler ◽  
Ann Thomas ◽  
Lanes Andrea ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Retrospective Cohort ◽  
Natural Cycle ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Progesterone Supplementation ◽  
Natural Cycles

Abstract Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles to luteinize the endometrium and prepare it for implantation, but little data is available to show if this is beneficial in true natural cycles. We evaluated the use of luteal phase progesterone supplementation for cryopreserved/warmed blastocyst transfers in true natural cycles not using an ovulatory trigger.Methods: Retrospective cohort study in a single academic medical center. We studied the use of luteal phase progesterone supplementation in patients undergoing true natural cycle cryopreserved blastocyst embryo transfers. Our primary outcome measure was ongoing pregnancy rate, with other pregnancy outcomes being evaluated (i.e. implantation rate, miscarriage rate, ectopic rate, and multifetal gestation). Categorical data were analyzed utilizing Fisher’s exact test and all binary variables were analyzed using log-binomial regression to produce a risk ratio. Results: 229 patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p=0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p= 0.7483), positive HCG rate (62.4% vs. 57.5%, p=0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p=0.2622), ectopic pregnancy rate (0% vs. 1.3%, p=0.3493), or multifetal gestations (7.4% vs. 3.8%, p=0.3166).Conclusion(s): The addition of luteal phase progesterone support in true natural cycle cryopreserved blastocyst embryo transfers did not improve pregnancy outcomes and therefore the routine use in practice cannot be recommended based on this study, but the utilization should not be discouraged without further studies. Capsule: Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.

scholarly journals The Clinical Relevance of Luteal Phase Progesterone Support in True Natural Cycle Cryopreserved Blastocyst Stage Embryo Transfers: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Ian Waldman ◽  
Catherine Racowsky ◽  
Emily Disler ◽  
Ann Thomas ◽  
Lanes Andrea ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Retrospective Cohort ◽  
Natural Cycle ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Progesterone Supplementation ◽  
Natural Cycles

Abstract Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles in order to luteinize the endometrium and prepare it for implantation, but little data is available if this is necessary in true natural cycles. We evaluated the use of luteal phase progesterone supplementation for cryopreserved/warmed blastocyst transfers in natural cycles not using an ovulatory trigger.Methods: Retrospective cohort study in a single academic medical center. We studied the use of luteal phase progesterone supplementation in patients undergoing true natural cycle cryopreserved blastocyst embryo transfers. Our primary outcome measure was ongoing pregnancy rate, with other pregnancy outcomes being evaluated (i.e. implantation rate, miscarriage rate, ectopic rate, and multifetal gestation). Categorical data were analyzed utilizing Fisher’s exact test and non-parametric data were analyzed using the Wilcoxon rank sum test. Results: 229 patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p=0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p= 0.7483), positive HCG rate (62.4% vs. 57.5%, p=0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p=0.2622), ectopic pregnancy rate (0% vs. 1.3%, p=0.3493), or multifetal gestations (7.4% vs. 3.8%, p=0.3166).Conclusion(s): The addition of luteal phase progesterone support in true natural cycle cryopreserved blastocyst embryo transfers did not improve pregnancy outcomes and therefore the routine use in practice cannot be recommended based on this study, but the utilization should not be discouraged without further studies. Capsule: Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.

P–211 Double warming and double vitrification for euploid embryos does not affect implantation nor ongoing pregnancy rate

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
B A Hashimi
Keyword(s):  
Statistical Analysis ◽  
Pregnancy Rate ◽  
Small Sample ◽  
Trophectoderm Biopsy ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Patient Counselling ◽  
Significant Difference ◽  
Group A ◽  
The Mean

Abstract Study question Does exposure of embryos to double vitrification and double warming affect the chances of ongoing pregnancy for patients undergoing PGT-A and transfer euploid embryos? Summary answer Our analysis shows that there is no statistically significant difference in implantation or ongoing pregnancy rate between single or double vitrification/warming cycles. What is known already The use of PGT-A is increasing in the last years and progressively more patients opting in for this, in order to reduce time to pregnancy. Implantation failures prior to genetic testing or the incidence of no-result embryos post PGT-A are some of the scenarios that expose the embryos to multiple rounds of vitrification/warming cycles. The exact effect that such exposure has on embryos is still to be investigated and confirmed as to whether it affects the outcome (i.e. implantation/ongoing pregnancy rate) or the future health of the child. Study design, size, duration Our analysis is a retrospective observation study of data collected from 151 consecutive frozen euploid embryo transfers (FET). These were performed at a single centre between January-December 2020. Two groups were created for this study. The first group includes euploid embryos that were transferred post being exposed to single vitrification/warming (n = 126). In the second group euploid embryos were exposed twice to vitrification/warming (n = 25). Statistical analysis using chi-square test and statistical significance was calculated when p ≤ 0.05. Participants/materials, setting, methods Blastocysts from 151 patients were split into two groups based on the number of vitrification/warming cycles that they underwent prior to FET. The first group includes embryos that were subjected to trophectoderm biopsy and were then vitrified (n = 126). The second group includes embryos that were initially vitrified without undergoing PGT-A analysis. Following implantation failures, their remaining embryos were warmed, biopsied and re-vitrified. Post PGT-A analysis euploid embryos were then re-warmed and transferred (n = 25). Main results and the role of chance For the first group (A), 450 blastocysts (day 5–7) were subjected to trophectoderm biopsy, where 5-cells taken, and embryos were then vitrified. Post PGT-A analysis 260 euploid embryos identified. From them 126 embryos transferred in frozen replacement cycles, where the mean embryo age for the group was 36.1±4.2. The grade of embryos transferred were of 4BC or better based on Gardner’s grading system. The implantation and ongoing pregnancy rate for this group was 62%. For the second group (B), 101 blastocysts (day 5–7) warmed, in order to undergo trophectoderm biopsy and were then re-vitrified. Post PGT-A analysis 49 euploid embryos identified. From them, 25 embryos transferred in frozen replacement cycles, where the mean maternal age for the group was 35.05±5.2. The grade of embryos transferred were of similar quality to group A. The implantation and ongoing pregnancy rate for this group was 64%. Statistical analysis confirmed that there is no statistical difference between the groups (p = 0.74). In addition, 60% of patients (n = 5) who had double vitrification, double biopsy and double warming have ongoing pregnancy. In conclusion, for transferrable quality euploid blastocysts, double vitrification has comparable reproductive outcomes as in single vitrification, thereby supporting the efficacy of double vitrification/warming when necessary. Limitations, reasons for caution This study uses a small sample size of patients. The data are observational and were retrospectively analysed so unknown confounders could not be assessed. The addition of more cycles and further multivariate analysis, including the child’s health is essential for confirmation of the findings. However, initial results are very reassuring. Wider implications of the findings: Our study has implications for clinical practice and patient counselling. Especially in patients that they choose to undergo PGT-A with pre-vitrified embryos post implantation failures with non PGT-A tested embryos. Trial registration number N/A

scholarly journals Comparison of clinical outcome of frozen embryo transfer after embryo selection based on morphokinetic versus morphologic criteria for freezing

2018 ◽  
Vol 5 (12) ◽  
pp. 2910-2917
Author(s):  
Le Nhat Quang ◽  
Le Thi Bich Tram ◽  
Nguyen Huyen Minh Thuy ◽  
Pham Duong Toan ◽  
Dang Quang Vinh ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Obstructive Azoospermia ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Frozen Embryos

Background: Results from the latest meta-analysis, in fresh cycles, showed that the application of time-lapse monitoring (TLM) together with an embryo-evaluating algorithm was associated with a significantly higher rate of ongoing pregnancy and a lower rate of early pregnancy loss. The aim of this study was to compare the clinical outcomes of frozen embryos classified according to morphokinetic versus morphologic criteria. Methods: This was a retrospective cohort study, conducted at IVFAS, An Sinh Hospital, Vietnam, from July 2014 to July 2017. Patients undergoing in vitro fertilization (IVF) treatment with antagonist protocol and having freeze-only on day 5 were included. Exclusion criteria were patients (i) treated with in-vitro maturation, (ii) having obstructive azoospermia, or (iii) having uterine abnormalities. Embryos were cultured up to day 5 in TLM system (Primo Vision, Vitrolife, Sweden) or in benchtop (G185, K System, Denmark). The quality of frozen embryos was evaluated based on morphokinetic or morphologic criteria. In the subsequent cycle, endometrial preparation was done by using exogenous estradiol and progesterone. Embryos were thawed and up to 2 embryos were transferred to the uterus. The primary outcome was ongoing pregnancy. The rate of post-thaw survival, post-thawed good/moderate embryo, clinical pregnancy, implantation, miscarriage and ectopic pregnancy were used as secondary endpoints. Results: A total of 276 patients were recruited, with 138 patients in the morphokinetic group and 138 patients in the morphologic group. Baseline characteristics were comparable between the two groups. There was no significant difference in ongoing pregnancy rate in morphokinetic versus morphologic group (57.2% vs. 60.1%, p=0.71). All secondary outcomes were comparable between the two groups. Conclusion: In frozen day-5 embryo transfer, the clinical outcomes were similar when embryos were classified according to morphokinetic versus morphologic criteria for freezing. Using morphokinetic criteria to select embryos for freezing did not improve the ongoing pregnancy rate, as compared to morphologic criteria.  

scholarly journals The clinical relevance of luteal phase progesterone support in true natural cycle cryopreserved blastocyst stage embryo transfers: a retrospective cohort study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ian N. Waldman ◽  
Catherine Racowsky ◽  
Emily R. Disler ◽  
Ann Thomas ◽  
Andrea Lanes ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Retrospective Cohort ◽  
Natural Cycle ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Progesterone Supplementation ◽  
Natural Cycles

Abstract Background More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles to luteinize the endometrium and prepare it for implantation, but little data is available to show if this is beneficial in true natural cycles. We evaluated the use of luteal phase progesterone supplementation for cryopreserved/warmed blastocyst transfers in true natural cycles not using an ovulatory trigger. Methods Retrospective cohort study in a single academic medical center. We studied the use of luteal phase progesterone supplementation in patients undergoing true natural cycle cryopreserved blastocyst embryo transfers. Our primary outcome measure was ongoing pregnancy rate, with other pregnancy outcomes being evaluated (i.e. implantation rate, miscarriage rate, ectopic rate, and multifetal gestation). Categorical data were analyzed utilizing Fisher’s exact test and all binary variables were analyzed using log-binomial regression to produce a risk ratio. Results Two hundred twenty-nine patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p = 0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p = 0.7483), positive HCG rate (62.4% vs. 57.5%, p = 0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p = 0.2622), ectopic pregnancy rate (0% vs. 1.3%, p = 0.3493), or multifetal gestations (7.4% vs. 3.8%, p = 0.3166). Conclusion(s) The addition of luteal phase progesterone support in true natural cycle cryopreserved blastocyst embryo transfers did not improve pregnancy outcomes and therefore the routine use in practice cannot be recommended based on this study, but the utilization should not be discouraged without further studies. Capsule Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.

scholarly journals Natural Cycle Results in Lower Implantation Failure than Ovarian Stimulation in Advanced-Age Poor Responders Undergoing IVF: Fertility Outcomes from 585 Patients

2021 ◽  
Author(s):  
Maria Paola De Marco ◽  
Giulia Montanari ◽  
Ilary Ruscito ◽  
Annalise Giallonardo ◽  
Filippo Maria Ubaldi ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Poor Responder ◽  
Advanced Age ◽  
Poor Responders ◽  
Natural Cycle ◽  
Significant Difference ◽  
Over 40 Years

AbstractTo compare pregnancy rate and implantation rate in poor responder women, aged over 40 years, who underwent natural cycle versus conventional ovarian stimulation. This is a retrospective single-center cohort study conducted at the GENERA IVF program, Rome, Italy, between September 2012 and December 2018, including only poor responder patients, according to Bologna criteria, of advanced age, who underwent IVF treatment through Natural Cycle or conventional ovarian stimulation. Between September 2012 and December 2018, 585 patients were included within the study. Two hundred thirty patients underwent natural cycle and 355 underwent conventional ovarian stimulation. In natural cycle group, both pregnancy rate per cycle (6.25 vs 12.89%, respectively, p = 0.0001) and pregnancy rate per patient101 with at least one embryo-transfer (18.85 vs 28.11% respectively, p = 0.025) resulted significant reduced. Pregnancy rate per patient managed with conventional ovarian stimulation resulted not significantly different compared with natural cycle (19.72 vs 15.65% respectively, p = 0.228), but embryo implantation rate was significantly higher in patients who underwent natural cycle rather than patient subjected to conventional ovarian stimulation (13 vs 8.28% respectively, p = 0.0468). No significant difference could be detected among the two groups in terms of abortion rate (p = 0.2915) or live birth pregnancy (p = 0.2281). Natural cycle seems to be a valid treatment in patients over 40 years and with a low ovarian reserve, as an alternative to conventional ovarian stimulation.

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