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Purpose <p>To evaluate whether the outcomes and characteristics of a first IVF/ICSI cycle are associated with embryological and clinical outcomes in a subsequent cycle performed within 2&#xa0;years.</p> Methods <p>This retrospective single-center observational study included 1190 couples undergoing two stimulated ICSI cycles with planned blastocyst culture between 2015 and 2020. Associations between first- and second-cycle outcomes were analyzed, including oocyte yield, blastocyst development, and live birth. The effect of the inter-cycle interval was assessed using multivariate models.</p> Results <p>The mean maternal age was 38.7&#xa0;years, and the mean AMH level was 1.7&#xa0;ng/ml. Second cycles showed improved embryological outcomes, including higher numbers of retrieved cumulus–oocyte complexes (COCs), increased blastocyst yield, and higher blastocyst rate per COC. Overall, 50% of patients retrieved more COCs in the second cycle, and 87% of those with no COCs in the first cycle obtained ≥ 1 in the second. A longer inter-cycle interval was negatively associated with outcomes, reducing the likelihood of retrieving more COCs (OR 0.96 per month, 95% CI 0.93–0.98), obtaining more blastocysts (OR 0.95, 95% CI 0.93–0.98), and improving blastocyst rate (OR 0.96, 95% CI 0.94–0.99). First-cycle outcomes were not associated with live birth probability in the second cycle, which was instead associated with maternal age and the number of COCs previously retrieved.</p> Conclusions <p>First-cycle outcomes should not discourage further attempts, as subsequent cycles may yield improved embryological results. A shorter interval between cycles represents a modifiable factor associated with better outcomes. These findings support early re-treatment and a multicycle counseling approach to optimize cumulative live birth rates, especially as maternal age and ovarian reserve remain the most important predictors of success even in second attempts.</p>

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Another round, another chance: oocyte developmental competence and outcomes in second IVF attempts—the earlier, the better

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Alessandro Ruffa,
  • Danilo Cimadomo,
  • Marilena Taggi,
  • Federica Innocenti,
  • Erika Pittana,
  • Federica Battista,
  • Gemma Fabozzi,
  • Michele Morelli,
  • Maurizio Guido,
  • Laura Albricci,
  • Giulia Fiorentino,
  • Laura Rienzi,
  • Filippo Maria Ubaldi,
  • Alberto Vaiarelli

摘要

Purpose

To evaluate whether the outcomes and characteristics of a first IVF/ICSI cycle are associated with embryological and clinical outcomes in a subsequent cycle performed within 2 years.

Methods

This retrospective single-center observational study included 1190 couples undergoing two stimulated ICSI cycles with planned blastocyst culture between 2015 and 2020. Associations between first- and second-cycle outcomes were analyzed, including oocyte yield, blastocyst development, and live birth. The effect of the inter-cycle interval was assessed using multivariate models.

Results

The mean maternal age was 38.7 years, and the mean AMH level was 1.7 ng/ml. Second cycles showed improved embryological outcomes, including higher numbers of retrieved cumulus–oocyte complexes (COCs), increased blastocyst yield, and higher blastocyst rate per COC. Overall, 50% of patients retrieved more COCs in the second cycle, and 87% of those with no COCs in the first cycle obtained ≥ 1 in the second. A longer inter-cycle interval was negatively associated with outcomes, reducing the likelihood of retrieving more COCs (OR 0.96 per month, 95% CI 0.93–0.98), obtaining more blastocysts (OR 0.95, 95% CI 0.93–0.98), and improving blastocyst rate (OR 0.96, 95% CI 0.94–0.99). First-cycle outcomes were not associated with live birth probability in the second cycle, which was instead associated with maternal age and the number of COCs previously retrieved.

Conclusions

First-cycle outcomes should not discourage further attempts, as subsequent cycles may yield improved embryological results. A shorter interval between cycles represents a modifiable factor associated with better outcomes. These findings support early re-treatment and a multicycle counseling approach to optimize cumulative live birth rates, especially as maternal age and ovarian reserve remain the most important predictors of success even in second attempts.