Lv Jiaxin, Guo Wei, Tian Tian, Chen Lixue, Zhen Xiumei, Li Rong, Qiao Jie, Yang Rui
Centre for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Hai Dian District, No. 49 Hua Yuan Bei Road, Beijing, 100191, China.
National Clinical Research Centre for Obstetrics and Gynecology, Beijing, 100191, China.
J Assist Reprod Genet. 2025 Jun 14. doi: 10.1007/s10815-025-03544-z.
Natural cycle in vitro fertilization (NC-IVF) represents a convenient and safe assisted reproductive technology, making it particularly advantageous for patients with poor ovarian response (POR). This research evaluates the effectiveness of NC-IVF for women with POR, aiming to inform personalized treatment decisions.
This retrospective cohort study encompassed 13,013 cycles involving women diagnosed with poor ovarian response according to the Bologna criteria. These patients underwent either natural cycles or controlled ovarian stimulation cycles. The primary outcome measure was the cumulative live birth rates, and the secondary outcomes included laboratory and clinical outcomes.
A total of 1073 natural cycles and 11,940 COS cycles were analyzed, with 5956 undergoing low-dose gonadotropin treatment and 5984 receiving high-dose gonadotropin. The basic characteristics were comparable among the three groups. In both fresh and frozen embryo transfer cycles, clinical pregnancy rates, implantation rates, and live birth rates were comparable across all three groups. Furthermore, no statistically significant differences were observed in cumulative live birth rates or time to first live birth between the groups examined. Expenditures in the natural cycle group were substantially lower than those in both COS cohorts. Importantly, further analysis indicated that there were no significant differences among the three groups concerning either pregnancy complications or neonatal outcomes.
Our findings indicate that for women demonstrating a poor ovarian response, NC treatment yields comparable pregnancy and live birth rates when compared to controlled ovarian stimulation methods. The natural cycle represents a safe, effective, and economically viable treatment option for this patient population.
自然周期体外受精（NC-IVF）是一种便捷且安全的辅助生殖技术，对卵巢反应不良（POR）的患者尤为有利。本研究评估NC-IVF对POR女性的有效性，旨在为个性化治疗决策提供依据。
这项回顾性队列研究纳入了13013个周期，涉及根据博洛尼亚标准诊断为卵巢反应不良的女性。这些患者接受了自然周期或控制性卵巢刺激周期。主要结局指标是累积活产率，次要结局包括实验室和临床结局。
共分析了1073个自然周期和11940个COS周期，其中5956个接受低剂量促性腺激素治疗，5984个接受高剂量促性腺激素治疗。三组的基本特征具有可比性。在新鲜胚胎移植周期和冷冻胚胎移植周期中，三组的临床妊娠率、着床率和活产率均具有可比性。此外，在检查的组间，累积活产率或首次活产时间没有观察到统计学上的显著差异。自然周期组的费用明显低于两个COS队列。重要的是，进一步分析表明，三组在妊娠并发症或新生儿结局方面没有显著差异。
我们的研究结果表明，对于卵巢反应不良的女性，与控制性卵巢刺激方法相比，NC治疗产生的妊娠率和活产率相当。自然周期是该患者群体一种安全、有效且经济可行的治疗选择。
