Journal
GYNECOLOGICAL ENDOCRINOLOGY
Volume 38, Issue 9, Pages 736-741Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/09513590.2022.2100339
Keywords
Poor ovarian response; Poseidon classification; Bologna criteria; in vitro fertilization; ovarian stimulation; AMH
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The study aims to evaluate whether an unexpected poor response in women with adequate ovarian reserve leads to a reduction in the pregnancy rate in IVF cycles. The results suggest that the number of available oocytes significantly affects the success rate of IVF cycles with unexpected impaired ovarian response.
Objective To evaluate whether an unexpected poor response (cases with <= 3 oocytes) leads to a reduction in the pregnancy rate in IVF cycles compared to a suboptimal response (controls with 4-9 oocytes) in women with adequate ovarian reserve. Methods A nested case-control study performed in a retrospective cohort of couples undergoing IVF at the Infertility Unit of the ASST Lariana. Cases and controls had adequate ovarian reserve and were matched 1:1 for female age and number of previous cycles. Cumulative clinical pregnancy rate per oocyte retrieval was the main outcome. Results Overall, 113 cases and 113 matched controls were included; the median number of available oocytes was 2 and 6, respectively. The cumulative pregnancy rate per cycle was significantly reduced in cases compared to controls with a crude odds ratio = 0.45 [95% Confidence Interval: 0.28-0.82]. A binomial logistic model indicated that an increase in one oocyte increases the odds for cumulative pregnancy rate per cycle by 1.27 in women with 9 oocytes or less. The cumulative pregnancy rates per cycle in cases and controls, according to female age were respectively: 29% versus 54% in patients aged <35 years (p = 0.036); 22% versus 43% in patients aged 36-39 years (p = 0.048) and 11% versus 13% in patients 40-45 years old (p = 0.72). Patients belonging to older age groups showed decreasing probability of cumulative clinical pregnancy rates both among cases and controls group (p < 0.05). Conclusions The number of available oocytes significantly affects the probability of success in IVF cycles with unexpected impaired ovarian response.
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