A successful pregnancy following ‘double rescue’ egg retrieval in a woman with Natural cycle IVF

A case is reported of a patient with critically low anti-mullerian hormone (AMH) having successful ‘rescue’ oocyte retrieval in natural in vitro fertilization (IVF) cycle 24 hours after the initial procedure had resulted in no oocyte being collected. Following administration of 10,000 units human chorionic hormone (hCG) a second retrieval was performed 24 hours after the first, producing one Metaphase-I oocyte. After in vitro maturation (IVM) over 4 hours in oocyte maturation medium, introcytoplasmic sperm injection (ICSI) was performed. A subsequent transfer of a 2-cell embryo proceeded on day 2. A positive hCG was recorded 15 days after embryo transfer (ET), and a viable clinical pregnancy has been confirmed. We believe this is the first reported case of a successful egg collection following a prior failed follicle aspiration in Natural IVF cycle. Factors such as good peri-follicular flow and initial follicular fluid cell content are probably essential before attempting a repeat procedure. This report highlights the importance of rescue IVM when an immature oocyte is collected.