{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:54:58Z","timestamp":1791402898098,"version":"4.3.3"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T00:00:00Z","timestamp":1720915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T00:00:00Z","timestamp":1720915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate whether trigger and oocyte collection at a smaller follicle size decreases the risk of premature ovulation while maintaining the reproductive potential of oocytes in women with a severely diminished ovarian reserve undergoing modified natural\u2010cycle\n                      <jats:italic>in\u2010vitro<\/jats:italic>\n                      fertilization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort study including women who had at least one unsuccessful cycle (due to no response) of conventional ovarian stimulation with a high dosage of gonadotropins and subsequently underwent a modified natural cycle with a solitary growing follicle (i.e. only one follicle &gt;\u200910\u2009mm at the time of trigger). The association between follicle size at trigger and various cycle outcomes was tested using regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 160 ovarian stimulation cycles from 110 patients were included in the analysis. Oocyte pick\u2010up (OPU) was performed in 153 cycles and 7 cycles were canceled due to premature ovulation. Patients who received their trigger at smaller follicle sizes (\u2264\u200915\u2009mm) had significantly lower rates of premature ovulation and thus higher rates of OPU (98.9%\n                      <jats:italic>vs<\/jats:italic>\n                      90.8%; odds ratio, 9.56 (95%\u2009CI, 1.58\u2013182.9);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.039) compared with those who received their trigger at larger follicle sizes (&gt;\u200915\u2009mm). On multivariable analysis, smaller follicle sizes at trigger (&gt;\u200910 to 13\u2009mm, &gt;\u200913 to 15\u2009mm, &gt;\u200915\u2009mm to 17\u2009mm) were not associated significantly with a lower rate of cumulus\u2013oocyte complex (COC) retrieval, metaphase\u2010II (MII) oocytes or blastulation when compared to the &gt;\u200917\u2010mm group. On sensitivity analysis including only the first cycle of each couple, the maturity rate among those with COC retrieval was highest in follicle sizes &gt;\u200915 to 17\u2009mm (92.3%) and &gt;\u200913 to 15\u2009mm (91.7%), followed by &gt;\u200910 to 13\u2009mm (85.7%) and lowest in the &gt;\u200917\u2010mm group (58.8%). During the study period, five euploid blastocysts developed from 48 fertilized MII oocytes with follicle sizes of 12\u2009mm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), 14\u2009mm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) and 16\u2009mm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) at trigger. Of those, four were transferred and resulted in two live births, both of which developed from follicles with a size at trigger of 12\u2009mm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ideal follicle size for triggering oocyte maturation may be smaller in women with a severely diminished ovarian reserve managed on a modified natural cycle when compared to conventional cut\u2010offs. The risk of OPU cancellation was significantly higher in women triggered at follicle size &gt;\u200915\u2009mm and the yield of mature oocytes was not adversely affected in women triggered at follicle size &gt;\u200913 to 15\u2009mm compared with &gt;\u200915 to 17\u2009mm. Waiting for follicles to reach sizes &gt;\u200917mm may be detrimental to achieving optimal outcome. \u00a9 2024 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.27611","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T04:27:52Z","timestamp":1707798472000},"page":"245-252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Do women with severely diminished ovarian reserve undergoing modified natural\u2010cycle\n                    <i>in\u2010vitro<\/i>\n                    fertilization benefit from earlier trigger at smaller follicle size?"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6209-4223","authenticated-orcid":false,"given":"B.","family":"Lawrenz","sequence":"first","affiliation":[{"name":"ART Fertility Clinic, Royal Marina Village  Abu Dhabi United Arab Emirates"},{"name":"Department of Reproductive Medicine UZ Ghent  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Kalafat","sequence":"additional","affiliation":[{"name":"ART Fertility Clinic, Royal Marina Village  Abu Dhabi United Arab Emirates"},{"name":"Faculty of Medicine, Department of Obstetrics and Gynecology Koc University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Ata","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Obstetrics and Gynecology Koc University  Istanbul Turkey"},{"name":"ART Fertility Clinic, Umm Suqeim  Dubai United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Melado","sequence":"additional","affiliation":[{"name":"ART Fertility Clinic, Royal Marina Village  Abu Dhabi United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Del 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