A Preliminary Report

積少成多試管嬰兒：高齡不孕、卵巢功能低下的求子新策略（初步報告）

蔡鋒博,陳昭雯,林昭彰,張月嬌,陳曉青,徐慧鈴,潘孟麗,張琇媛,施俐君　博元婦產科,不孕症試管嬰兒中心

Feng-Po Tsai,Chao-Wen Chen,Chao-chang Lin,Yueh-Chiao Chang,Hsiao-Ching Chen,Hui-Ling Hsu,Meng-LI Pan,Hsiu-Yuan Chang,Li-Chun Shr　Poyuan Women clinic,IVF centre,Chawghua Taiwan

Introduction：

Low responders (LR) to ovarian stimulation represent a substantial proportion of the patients enrolled in assisted reproduction programmes. The setbacks of LR are the number of oocytes retrieved and suboptimal oocyte maturation, embryo quality and cycle/transfer cancellation rates with respect to age-matched normoresponders.

Materials and methods：

A total of 5 LR patients, defined as women in whom less than 5 oocytes were retrieved in a single ovarian stimulation , were prospectively included in the study. 5 patients were selected after evaluating their ovarian function.

All 5 patients who met the criteria of having a FSH concentration >11IU/ml on cycle day 3 and an antral follicle (2–10mm during early follicular phase) count <6 among both ovaries   were considered eligible for the study. Additionally, anti-Müllerian hormone blood concentrations <1pmol/l were also considered as an inclusion criteria .

After ovarian stimulation and oocyte retrieval , mature oocytes  were inseminated . The embryos if any were frozen and stored for use in a subsequent  cycle. The procedure was repeated in two or more stimulation cycles and met the  need for a total number of 3 or 4 embryos to be transferred  in  a consecutive cycle a standard situation for a normoresponders.

Result:

All 5 LR patients got pregnant successfully . One patient had a twin pregnancy and  four  were singleton.

Conclusion：

Even though single embryo transfer is considered as an effective means of reducing multiple pregnancy, single embryo transfer may not be the preferred choice for all patients undergoing IVF/ICSI. Since the chance per embryo declines with advancing female age, increasing number of transferred embryo can compensate for this declining chance.

Accumulation of embryos by vitrification and simultaneous transfer represents a successful alternative for Low Responder patients, yielding comparable success rates to those in normoresponders and avoiding adverse effects of a low response.