Squeeze and Freeze, A Periodic Consecutive Oocyte Retrieval Method for Poor Ovarian Responders, Increases The Chance of Childbearing

Abstract

Purpose To assess if consecutive oocyte retrieval (OR) of more than three times could be an effective method to obtain competent embryos becoming babies. Methods To maximize the chances of pregnancy for refractory infertile women, we designed a new treatment course, “Squeeze and freeze.” In this method, ovarian stimulation was initiated whenever the antral follicle was visible using ultrasound, regardless of the menstrual cycle stage for 3 months, aiming to retrieve all possible oocytes and collecting the maximum number of competent embryos for subsequent transfer. Eighty-eight patients underwent 101 treatment courses, in which retrievals at an average of 4.8 times were performed for 3 months. The clinical results and obstetric outcomes were retrospectively reviewed. Results The ratio of matured oocytes, 2PN embryos, available embryos, fair blastocysts per oocyte, and number of available embryos or fair blastocysts per retrieval did not differ between the two initial and later attempts. Similarly, no significant differences were observed in these parameters between the follicular- and luteal-phase retrievals. After subsequent embryo transfer, 62 patients achieved clinical pregnancy, 49 had an ongoing pregnancy, 47 delivered healthy babies, and 8 conceived a second baby. Conclusion Periodic consecutive OR is an efficient infertility treatment for refractory women. In this method, as many oocytes as possible are obtained from a patient in a limited period at the earliest stage of their life. More than three consecutive ORs, including luteal-phase ORs, could obtain competent embryos efficiently, increasing the chances of childbearing.