Poor response after hormonal stimulation for in vitro fertilization is not related to ovarian aging

Objective: To investigate whether the diminished efficacy of ART in young poor responders compared to young normal responders is due to a quantitative or a qualitative oocyte factor. Design: Retrospective comparative analysis. Setting: University-based infertility center. Patient(s): Nine thousand six hundred forty-four patients who underwent ART procedures at our hospital from 1993 until 2001. Intervention(s): Controlled ovarian hyperstimulation, ultrasonographic monitoring of the ovarian response, oocyte retrieval, ART procedure, embryo transfer, and follow-up of pregnant patients until 12 weeks of amenorrhea. Main Outcome Measure(s): Clinical rates of pregnancy and miscarriage. Result(s): Nine thousand six hundred forty-four ART cycles were analyzed. The pregnancy rate for poor responders was significantly lower than for normal responders (17% vs. 35%). In cycles in which two good-quality embryos were transferred, the pregnancy rate was similar in poor responders and normal responders (33% vs. 42%). The rate of miscarriage was no higher in poor responders than normal responders. Conclusion(s): Young poor responders have a lower pregnancy rate than young normal responders because they have fewer oocytes, which leads to fewer good-quality embryos to choose from for transfer. The quality of their oocytes and embryos is not inferior to that of normal responders.