How many eggs retrieved in IVF are good numbers?

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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.

References

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

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