Early Egg Retrieval in Women with DOR/LFOR

Regular readers of these pages will recall that CHR investigators earlier in 2015 published a paper in the prestigious Journal of Endocrinology (Wu et al., Aging-related premature luteinization of granulosa cells is avoided by early oocyte retrieval. 2015;326:167-180), in which they reported the discovery that in older women above age 43 (i.e. in women who usually demonstrate LFOR because of their advanced age) the intrafollicular environment matures quicker than in younger women, thus leading to so-called premature luteinization of the follicle and over-matured eggs.

As a consequence of that finding, CHR’s physicians started retrieving eggs from older women’s follicles earlier by giving the ovulation-inducing hCG shot when the lead follicle reaches 16mm rather than at the usual 19-21mm. This simple management change in older women over age 43 more than doubled IVF pregnancy chances.

We can now report that the same group of CHR investigators completed a follow-up study in younger women with premature ovarian aging (POA) (i.e., in women with premature LFOR, characterized by prematurely elevated FSH and/or prematurely low AMH levels), and, lo and behold, found that their follicles demonstrated exactly the same molecular signature of premature luteinization found in older women above age 43. Even more remarkably, with early egg retrieval at ca. 16mm, the improvements in clinical pregnancy rates in younger women with POA were even more pronounced than in older patients.

Since a manuscript, describing these findings in POA patients, was just submitted for publication, we are not yet at liberty to go into further detail. Only so much: we predict that earlier egg retrieval in women with LFOR will become standard of care in IVF worldwide, once our colleagues recognize how favorably it affects their outcomes in women with LFOR.

This is a part of February 2016 issue of the VOICE. Read this issue in PDF.

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.