Outcome Following Oocyte Retrieval in Women with Marked Diminished Oocyte Reserve Where the Only Oocyte Obtained Was in A Metaphase I Stage

Author(s): Jerome H Check, Donna Summers, Danya Horwath, Madison Neulander, Brooke A Neumann DO

Women with marked diminished oocyte reserve (DOR) may still require in vitro fertilization embryo transfer (IVF-ET) because of severe male subfertility or damaged fallopian tubes. Live deliveries have been reported even with only one oocyte retrieved, especially with a mild ovarian stimulation technique known as the FSH receptor up-regulation technique. Though live deliveries have been reported using rescued metaphase (M) I oocytes cultured to the MII stage, live delivered pregnancy rates (LDPRs) are markedly reduced. The purpose of this study was to determine if a live delivery is possible where the only oocyte retrieved was a MI oocyte who already has a much reduced chance of conception even if a MII oocyte had been obtained. A 25- year retrospective study identified 42 women aged < 39.9 and 40 women > age 40 who had only a single MI egg retrieved. In the younger group, 14 women proceeded to ET 4 days after egg retrieval and 1 had a live delivery. For women >40, 15 women proceeded to ET but there were no live deliveries. Since a precedent has been set that a live delivery is possible, despite marked DOR and one MI egg retrieved, it seems reasonable to advise extended culture with the hope of transferring a viable embryo.