Hormone-free Antral Retrieval for Viable Embryo Storage & Transfer

Inclusion Criteria:

* Signed informed consent.
* Female participant aged 18-35 years.
* Diagnosis of infertility requiring IVF/ICSI, including unexplained infertility or mild male factor infertility.
* BMI 18-30 kg/m².
* AMH ≥2.5 ng/mL.
* AFC ≥12.
* Basal FSH \<8 IU/L.
* Ovaries accessible for transvaginal retrieval.
* Willing to undergo serial unstimulated TVORs with adaptive retrieval timing.
* Willing to undergo CAPA-IVM, ICSI, blastocyst culture, PGT-A, embryo vitrification/accumulation, and single euploid embryo transfer.
* Willing to undergo serial ultrasound and endocrine monitoring.
* Willing and able to comply with study procedures and follow-up.

Exclusion Criteria:

* Prior ovarian surgery.
* Ovarian endometrioma.
* Inaccessible ovaries.
* Significant uterine factor expected to compromise implantation, pregnancy, or live birth.
* Significant medical comorbidity that would increase risk of TVOR, pregnancy, or study participation.
* AMH \<2.5 ng/mL.
* AFC \<12.
* Basal FSH ≥8 IU/L.
* BMI \<18 or \>30 kg/m².
* Current smoking or nicotine use within 3 months of screening.
* Active pelvic infection, untreated STI, or acute urinary tract infection.
* Contraindication to transvaginal oocyte retrieval, anesthesia/sedation, pregnancy, or antibiotic prophylaxis.
* Known chromosomal abnormality in the participant or sperm source that would confound study outcome assessment.
* Severe male factor infertility requiring surgical sperm retrieval, unless specifically permitted by the final protocol.
* Recent exposure to teratogenic radiation, drugs, or toxins.
* Current participation in another interventional clinical trial that may confound outcomes.
* Previous participation in the CARE study.