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Predicting IVF outcome in poor ovarian responders

BACKGROUND: Poor responders to ovarian stimulation are one of the most challenging populations to treat. As a failed cycle can cause a considerable emotional and economical loss, adequate fertility counseling addressing patients’ expectations are highly important when facing patients with poor ovari...

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Autores principales: Lebovitz, Oshrit, Haas, Jigal, Mor, Nitzan, Zilberberg, Eran, Aizer, Adva, Kirshenbaum, Michal, Orvieto, Raoul, Nahum, Ravit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524122/
https://www.ncbi.nlm.nih.gov/pubmed/36180882
http://dx.doi.org/10.1186/s12905-022-01964-y
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author Lebovitz, Oshrit
Haas, Jigal
Mor, Nitzan
Zilberberg, Eran
Aizer, Adva
Kirshenbaum, Michal
Orvieto, Raoul
Nahum, Ravit
author_facet Lebovitz, Oshrit
Haas, Jigal
Mor, Nitzan
Zilberberg, Eran
Aizer, Adva
Kirshenbaum, Michal
Orvieto, Raoul
Nahum, Ravit
author_sort Lebovitz, Oshrit
collection PubMed
description BACKGROUND: Poor responders to ovarian stimulation are one of the most challenging populations to treat. As a failed cycle can cause a considerable emotional and economical loss, adequate fertility counseling addressing patients’ expectations are highly important when facing patients with poor ovarian response. The study aimed to evaluate reproductive outcomes and to identify factors associated with live birth (LB) after fresh autologous IVF/intracytoplasmic sperm injection (ICSI) cycles of patients fulfilling the Bologna criteria for poor ovarian response (POR). METHODS: A retrospective study included 751 IVF/ICSI treatment cycles which yielded up to three retrieved oocytes, at a tertiary referral hospital between January 2016 and February 2020. A logistic regression analysis was used to adjust for confounders. RESULTS: Clinical pregnancy and LB rate per cycle were significantly higher among women younger versus older than 40 years (9.8% and 6.8% vs 4.5% and 2.1%, p < 0.01, respectively). Patients who achieved LB were significantly younger, had higher number of oocytes retrieved, fertilization rate and top-quality embryos (p < 0.05). Multivariable regression analysis identified patient’s age (OR 0.90; 95% CI 0.845–0.97; p = 0.005) and mean number retrieved oocytes (OR 1.95; 95% CI 1.20–3.16; p = 0.007) as factors significantly associated with the probability of a LB. CONCLUSIONS: The woman’s age and the number of retrieved oocytes are both independent predicting factors of live birth in poor ovarian responders. Considering the risks, the high financial investment and poor reproductive outcomes involved in IVF treatments, raises questions regarding the adequacy of providing treatments in these patients' population. POR younger than 40 years may represent a possible exception due to acceptable probability for a LB.
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spelling pubmed-95241222022-10-01 Predicting IVF outcome in poor ovarian responders Lebovitz, Oshrit Haas, Jigal Mor, Nitzan Zilberberg, Eran Aizer, Adva Kirshenbaum, Michal Orvieto, Raoul Nahum, Ravit BMC Womens Health Research BACKGROUND: Poor responders to ovarian stimulation are one of the most challenging populations to treat. As a failed cycle can cause a considerable emotional and economical loss, adequate fertility counseling addressing patients’ expectations are highly important when facing patients with poor ovarian response. The study aimed to evaluate reproductive outcomes and to identify factors associated with live birth (LB) after fresh autologous IVF/intracytoplasmic sperm injection (ICSI) cycles of patients fulfilling the Bologna criteria for poor ovarian response (POR). METHODS: A retrospective study included 751 IVF/ICSI treatment cycles which yielded up to three retrieved oocytes, at a tertiary referral hospital between January 2016 and February 2020. A logistic regression analysis was used to adjust for confounders. RESULTS: Clinical pregnancy and LB rate per cycle were significantly higher among women younger versus older than 40 years (9.8% and 6.8% vs 4.5% and 2.1%, p < 0.01, respectively). Patients who achieved LB were significantly younger, had higher number of oocytes retrieved, fertilization rate and top-quality embryos (p < 0.05). Multivariable regression analysis identified patient’s age (OR 0.90; 95% CI 0.845–0.97; p = 0.005) and mean number retrieved oocytes (OR 1.95; 95% CI 1.20–3.16; p = 0.007) as factors significantly associated with the probability of a LB. CONCLUSIONS: The woman’s age and the number of retrieved oocytes are both independent predicting factors of live birth in poor ovarian responders. Considering the risks, the high financial investment and poor reproductive outcomes involved in IVF treatments, raises questions regarding the adequacy of providing treatments in these patients' population. POR younger than 40 years may represent a possible exception due to acceptable probability for a LB. BioMed Central 2022-09-30 /pmc/articles/PMC9524122/ /pubmed/36180882 http://dx.doi.org/10.1186/s12905-022-01964-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Lebovitz, Oshrit
Haas, Jigal
Mor, Nitzan
Zilberberg, Eran
Aizer, Adva
Kirshenbaum, Michal
Orvieto, Raoul
Nahum, Ravit
Predicting IVF outcome in poor ovarian responders
title Predicting IVF outcome in poor ovarian responders
title_full Predicting IVF outcome in poor ovarian responders
title_fullStr Predicting IVF outcome in poor ovarian responders
title_full_unstemmed Predicting IVF outcome in poor ovarian responders
title_short Predicting IVF outcome in poor ovarian responders
title_sort predicting ivf outcome in poor ovarian responders
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524122/
https://www.ncbi.nlm.nih.gov/pubmed/36180882
http://dx.doi.org/10.1186/s12905-022-01964-y
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