Timing of Myo‑Inositol Discontinuation and Anticoagulation Management Before Oocyte Retrieval

Myo‑Inositol Discontinuation

Stop myo‑inositol on the day of the hCG or GnRH‑agonist trigger (when leading follicles have reached a diameter of ≥17–18 mm), which is approximately 35–37 hours before scheduled oocyte retrieval in women undergoing ovarian stimulation. This timing aligns the end of myo‑inositol’s role as an FSH second messenger with the initiation of final oocyte maturation. Evidence level: expert consensus 1

Low‑dose aspirin should be discontinued 3 days before oocyte retrieval and resumed the day after retrieval. This schedule is recommended for patients on aspirin therapy undergoing assisted reproductive technology. Evidence level: guideline recommendation 2
Low‑molecular‑weight heparin (LMWH) should be stopped 12–24 hours before oocyte retrieval and can be resumed on the same day of retrieval provided there is no clinically significant bleeding. This protocol applies to patients receiving LMWH during ART cycles. Evidence level: guideline recommendation 3
The anticoagulation timing protocols above are independent of myo‑inositol discontinuation; myo‑inositol should still be stopped on the trigger day as described. Evidence level: guideline recommendation [2][3]