When is the right time to stop autologous in vitro fertilization treatment in poor responders?

Declining oocyte quality and quantity with age are the main limiting factors in female reproductive success. Age of the female partner, ovarian reserve, the patient's previous fertility treatment outcomes, and the fertility center's pregnancy success data for specific patient profiles are used to predict live birth rates with in vitro fertilization (IVF) treatment. The chance of finding a euploid blastocyst or achieving live birth after the age of 45 is close to zero. Therefore, any IVF cycle using autologous oocytes after the age of 45 can be accepted as futile and should be discouraged. The number of mature eggs retrieved and the number of embryos available for transfer are the second most important predictors of pregnancy and live birth after female age. For patients aged <= 45 years, the recommendation for attempting IVF should be given considering the patient's age and the expected ovarian response. Before the start of the IVF cycle, patients with a very poor prognosis must be fully informed of the prognosis, risks, costs, and alternatives, including using donor oocytes. Alternative treatments to improve oocyte quality and decrease aneuploidy have the potential to change how clinicians treat poor responders. However, these treatments are not yet ready for clinical use. ((C) 2022 by American Society for Reproductive Medicine.)

Automated summary

Declining oocyte quality and quantity with age are the main factors affecting female reproductive success. Factors such as the female partner's age, ovarian reserve, previous fertility treatment outcomes, and pregnancy success data are used to predict live birth rates in IVF treatment. The chance of success after the age of 45 is extremely low, making IVF cycles with autologous oocytes discouraged. The number of mature eggs retrieved and available embryos for transfer are important predictors of pregnancy and live birth. Patients aged <= 45 should consider their age and expected ovarian response when deciding to attempt IVF. Patients with a poor prognosis should be fully informed about the prognosis, risks, costs, and alternatives before starting an IVF cycle.