Predicting pregnancy in women with poor ovarian response

This study looked at which factors can predict pregnancy following in vitro fertilization (IVF) for patients with a poor ovarian response (POR). It found that pregnancy was affected by age, body weight, ovarian reserve, and type of fertility medication.

For couples with infertility, IVF can greatly increase the chances of pregnancy. This procedure involves stimulating the ovaries to produce multiple oocytes (eggs). However, the ovaries do not always have a strong response to the fertility medications used during IVF. Poor ovarian response (POR) can reduce the chance of pregnancy through IVF.

Past IVF cycles where there were few oocytes collected can indicate POR. Also, POR is related to tests of ovarian reserve. Ovarian reserve is the ability of the ovaries to produce mature oocytes. Ovarian reserve can be tested using antral follicle count (AFC) and the amount of anti-Mullerian hormone (AMH).

Besides POR, many other factors influence the success of IVF. Knowing which factors influence IVF success for women with POR can help guide treatment.

This study used records from 6,580 patients who were undergoing IVF and had POR. The researchers grouped the patients according to their predicted chances of pregnancy. The POSEIDON criteria were used to group patients based on age, ovarian reserve, and past response to fertility medications.

The researchers used statistics to test which factors were related to birth rates. They found that birth rates decreased with age, starting around 34 years old. Birth rates were also higher for patients with higher ovarian reserve (AFC over 8).

They also found that birth rate was related to body mass index (BMI). Women who were thin had higher pregnancy rates (BMI under 23.4 kg/m²). Pregnancy was similar for women who had a normal weight but BMI higher than 23.4 kg/m², were overweight (BMI 25-29.9 kg/m²), or were slightly obese (BMI 30 – 35 kg/m²).

The protocol used for ovarian stimulation significantly affected birth rate. Early-follicular phase GnRH-agonist long protocol had higher birth rates. Compared to this method, using GnRH antagonist had 83% lower odds of birth.

This study found that age, ovarian reserve, and weight influenced IVF birth rates for women with POR.

Doctors may have recommended different fertility medications for women they expected to have a better response. This might have influenced the outcomes.