How many eggs retrieved in IVF are good numbers?
IVF becomes a popular technique for infertility treatment
since it was invented 30 years ago. During the procedure it is difficult to
predict the side effect and success for individuals. IVF success rate is
related to egg number retrieved in the procedure. What is the optimum number of
eggs for IVF? Is there a connection between egg numbers and live birth rate
(LBR)? Ji J et al analysed the data from 2007 and 2011 from total 2455 patients
who was undergoing first cycle of IVF treatment. All patients had normal
menstrual cycles and were stimulated with a long GnR agonist protocol.
Associations between egg number and LBR and miscarriage rate and the rate of
moderate-severe ovarian hyperstimulation syndrome (OHSS) were analysed. These
patients were divided into four groups according to the egg number retrieved:
0-5, 6-10,11-15 and >15. The fresh embryo transfer LBR and cumulative LBR
were assessed. Their data suggested that for IVF cycles stimulated with a long
protocol the optimal number of eggs for achieving a live birth is between 6-15.
With increased egg number, the incidence of moderate-severe OHSS was increased.
There was no significant difference in the miscarriage rates among the patient
groups.
There was another research studied the association between egg
number and the rates of ovarian hyperstimulation syndrome (OHSS) and live birth
in fresh IVF cycles. In this research they analysed data from 256381 IVF
cycles. Patients were divided into five groups according to the egg numbers
retrieved. The data showed that the LB rate increased up to 15 eggs, then
levelled (0-5: 17%, 6-10: 31.7%; 11-15: 39.3%; 16-20: 42.7%; 21-25: 43.8%; and
>25 oocytes: 41.8%). While the rate of OHSS became much more clinically
significant after 15 eggs (0-5: 0.09%; 6-10: 0.37%; 11-15: 0.93%; 16-20: 1.67%;
21-25: 3.03%; and >25 oocytes: 6.34%). These data showed that retrieval more
than 15 eggs significantly inceases OHSS risk without improving LB rate in
fresh IVF cycles.
Acupuncture reduces pain in IVF egg retrieval
Acupuncture has been used to assist IVF. There are different
approaches for the use. Using acupuncture on the day of egg retrieval could
help reduce pain. There was a study on this subject to observe analgesic effect
and safety of acupuncture in egg retrieval. In this study 316 patients
undergoing IVF were divided into two groups acupuncture plus anaesthesia group
(146 patients) and a simple anaesthesia (control) group (170 patients). The
treatments were carried out 30 min before egg retrieval. They found that pain
rating and pain score were significantly better for acupuncture group than that
for control group. The incidence rate of abdominal pain at 1hour and 2-5 hour
after egg retrieval was lower for acupuncture group. There was no side effect
found. Recently there was another study on the effect of acupuncture on pain in
egg retrieval. In this study there were 90 patients participated the study. The
treatments were also carried out 30 min before egg retrieval. Pain rated index
(PRI), visual analogy scale (VAS) and present pain intensity (PPI) were used to
measure pain. The result showed that PRI, VAS and PPI immediate after and 1
hour after egg retrieval were significantly lower for acupuncture group than
that for control group. They also found that neuropeptide level in follicular
fluid is higher in acupuncture group which may be the mechanism of acupuncture
analgesic effect on egg retrieval.
Nedeljkovic M et al
Forsch Komplementmed (2013) 20:112-8
Manheimer E et al
(2008) BMJ 8: 545-549
Zheng CH et al Evid Based
Complement Alternat Med (2012)2012:543924
Kong FY et al
Zhongguo Zhen Jiu (2012) 32:113-116
Chen J et al Zhongguo
Zhen Jiu (2009) 29:775-9
Cui W et al Zhongguo
Zhen Jiu (2011) 31:687-691
Dieterle S et al
Fertil Steril (2006) 85:1347-51
Isoyama D et al
Acupunct Med (2012) 30:85-8
Balk J et al
Complement Ther Clin Pract (2010) 16:154-7
Villahemosa et al
Acupunct Med 2013 31:157-62
Meng P et al Zhongguo
Zhen Jiu (2008) 28:451-5
Zhang J et al J
Tradit Chin Med (2013) 33:294-7
Steward RG et al
Fertil Steril (2014) S0015-0282
Ji J et al Hum Reprod
(2013) Jul 25
