A Lucky Opportunity: First-ever Confirmation of Highly Individualized Egg Retrieval (HIER) in a Natural Conception Cycle

To prevent oocyte-toxic premature luteinization of follicles during IVF cycles, which occurs earlier and earlier with advancing female age, our center has learned to advance oocyte retrieval appropriately over the last decade, a process we have given the acronym HIER (Highly Individualized Egg Retrieval). In principle, for practical reasons, the HIER concept was only applicable in IVF cycles. However, as a consequence of several lucky coincidences, we recently had the opportunity to apply HIER to a spontaneous conception. We here report this case to demonstrate that the HIER approach appears to be applicable independent of whether ovaries are exogenously stimulated or not. This case report expands utilization of HIER beyond IVF to practically all treatment cycles in infertility, in the process contradicting two long-held dogmas in worldwide infertility practice.