Clinique Ovo, Inc.

The goal of this clinical trial is to evaluate the safety and effectiveness of a personalized ovarian stimulation regimen in women aged 18 to 40 undergoing in vitro fertilization (IVF). The main question it aims to answer is:
- Does personalizing the starting doses of follitropin delta (REKOVELLE) and HP-hMG (MENOPUR) based on both age and body lead to similar results as anti-Müllerian hormone (AMH) and weight based dosing ?
Researchers will compare the new dosing regimen to the MARCS study results to see if this new approach leads to similar outcomes
Participants will:
* Receive ovarian stimulation using a personalized dose of REKOVELLE aND MENOPUR based on age and weight
* Be monitored through ultrasound imaging and blood tests to measure estradiol (E2) levels
* Undergo standard IVF procedures including egg retrieval and embryo assessment

Studies reported various risk factors for inadequate ovulation induction such as body mass index, low ovarian reserve, low baseline FSH and LH, and previous use of contraception or agonist.
The flexibility to use human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone agonist (GnRHa) in ovulation induction for antagonist protocol or progestin primed ovarian stimulation (PPOS) is an advantage helping fertility doctors to decrease the risk of ovarian hyperstimulation syndrome. However, luteinizing hormone (LH) levels <15UI/L and progesterone ≤11.13nmol/L eight to twelve hours post GnRHa trigger were highly correlated to failed oocyte pickup (FOP).
Rescue hCG have been found to increase favorable outcomes in patients with FOP. The presence of false FOP could be due pharmaceutical reasons and human error. Genuine FOP could be due to intrinsic ovarian pathology.
The FOP is defined as the absence of oocytes after ovarian stimulation and follicular aspiration. It is an uncomfortable situation for the patient and medical team to deal with due to the apparent expectations of favorable results.
Ovulation induction could be via GnRHa, HCG, or both in antagonist protocol and PPOS protocol. Long or short agonist protocol could be triggered only via HCG.

Studies reported that calcium signal deficiency or insufficiency during oocyte activation are related with embryo arrest and blastocyst quality. The utilization of Artificial Oocyte Activation (AOA) is safe and does not increase birth defects, cognition, language and motor skills. AOA is the first line of treatment in patients with globozoospermia (round headed spermatozoa). Poor responders in in-vitro fertilization (IVF) cycles represent a major challenge for fertility specialists and comprises about 10-15% of patients undergoing controlled ovarian hyperstimulation. The absence of synergy between the oocyte and sperm leads to a negative impact on oocyte activation. The European Society of Human and REproduction (ESHRE) recommends AOA in cases with failed fertilization/ low fertilization.