# Outcomes of Secondary Ovulation Induction Following Failed Oocyte Pick-Up in In Vitro Fertilization (IVF) Cycles: A Retrospective Observational Study

## TL;DR

This study finds that waiting 36 hours between a second trigger and egg retrieval improves outcomes for failed oocyte pick-up in IVF.

## Contribution

The study introduces a 36-hour interval as a novel approach to improve outcomes in failed oocyte pick-up cases during IVF.

## Key findings

- A 36-hour interval between trigger and OPU resulted in significantly higher oocyte retrieval rates compared to a 24-hour interval.
- Fertilization, blastocyst, and pregnancy rates were also significantly higher with the 36-hour interval.
- Communication between physicians and embryologists is crucial for managing FOPU cases effectively.

## Abstract

Introduction: Failed oocyte pick-up (FOPU) is the absence of oocyte retrieval from mature follicles after ovulation induction in in vitro fertilization (IVF) cycles. The incidence of FOPU is rare in IVF cycles.

Methods: This retrospective cohort single-center study compared a 36-hour time interval between a second trigger and ovum pick-up (OPU) in FOPU and a 24-hour time interval between a second trigger and OPU in FOPU. In total, 62 couples with FOPU between July 2011 and April 2024 were included in the study. Of the 62 patients included, 49 underwent a 36-hour time interval between trigger and OPU (group 1), and 13 couples underwent a 24-hour time interval between trigger and OPU (group 2). The primary outcome measured was oocyte retrieval, and the secondary outcomes were fertilization, blastocyst, and pregnancy rates.

Results: We compared 49 patients from group 1 and 13 from group 2. After a 36-hour time interval, oocyte retrieval in group 1 was significantly higher than that in group 2 (8.3 ± 5.7 versus 2.7 ± 3.8, p < 0.001). Furthermore, fertilization, blastocyst, and pregnancy rates were significantly higher in group 1 than in group 2, respectively (61% versus 13.8%, p < 0.001; 32.8% versus 0%, p < 0.001; and 37.8% versus 0%, p < 0.001).

Conclusion: Strong evidence for overcoming primary impaired oocyte retrieval is still lacking in the literature. However, a 36-hour time interval between a second trigger and OPU seems ideal for FOPU cases. Therefore, communication between the physician and embryologist is crucial during OPU to detect such cases, especially in couples with a history of FOPU.