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Conventional ovarian stimulation protocols intend to yield as many oocytes and embryos as possible to try to maximize the success of an in vitro fertilization (IVF) program. In reality, however, a series of studies over the last few years observed that live birth rates (LBRs) do not increase after a certain number of retrieved oocytes [1–3]; some studies even found a decline in LBRs when the number of oocytes was in excess of 18 [4] or blastocyst numbers above 5 [5]. Although the cumulative LBR keeps rising over and above the number of oocytes/embryos that maximizes per cycle live birth, the incidence of ovarian hyperstimulation syndrome (OHSS) and venous thromboembolism (VTE) also escalate in a parallel fashion [2;3;6]. A recent study, by restricting the stimulation dose to 150 IU/day, found only nine oocytes or four embryos optimizing the fresh cycle LBR [7].
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