Age, independent from ovarian reserve status, is the main prognostic factor in natural cycle in vitro fertilization

González-Foruria, Iñaki; Peñarrubia, Joana; Borrás, A; Manau, Dolors; Casals, Gemma; Peralta, Sara; Creus, Montserrat; Ferreri, Janisse; Vidal, Ester; Carmona, Francisco; Balasch, Juan; Fábregues, Francisco

doi:10.1016/j.fertnstert.2016.04.007

Cited by 43 publications

(33 citation statements)

References 24 publications

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“…In our study, 187 out of the 270 non-ART pregnancies ended up with live birth, suggesting the previously reported positive association of the EFI with the rate of live birth was mainly driven by its association with non-ART pregnancy. Although, age is frequently used to predict the chance of live birth or pregnancy [41,42], while lower ovarian reserve [43,44] and severity of the lesion [12,45] are the factors that might influence fertility outcomes, none of these studies were confined to the pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Use of endometriosis fertility index to predict non-ART pregnancy and live birth after endometriosis surgery based on optimal stratification

Fan

Kang

et al. 2020

Preprint

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Backround: The EFI, which was previously developed and validated externally, has shown predictive accuracy of non-ART pregnancy following surgery in infertile women with endometriosis. But up to now it was less accurate among the patients with lower scores based on the classification of the original literature. In addition, so far the only study has reported a strong association between the EFI and the live birth. However, the analysis of that study was done in women undergoing surgery rather than in those who had conceived post-operatively. Methods: 501 infertile women undergoing laparoscopic treatment of endometriosis were recruited and followed up for post-operative pregnancy outcomes. The associations of EFI with non-ART pregnancy and with live birth were investigated with survival analysis and the Cochrane-Armitage test. The optimal cut-offs for EFI were determined using the Maximally Selected Rank Statistics (Maxstat). Result(s): The follow-up rate was 92.4% with a mean duration of 38.5 months (range: 14.4-67.4 months). A total of 270 women (58.3%) conceived without ART, 187 (69.3%) had a live birth. A statistically significant association of EFI with non-ART pregnancy rate was observed (hazard ratio: 1.29, 95% confidence interval: 1.19-1.36; 95% confidence interval: 0.57-0.65). The Maxstat method suggested optimal EFI strata of 4, 6 and 8. The cumulative non-ART pregnancy rates 3 years after surgery were 15.0%, 47.1%, 67.6% and 73.6% for EFI scores of 0-4, 5-6, 7-8 and 9-10, respectively (Log-rank p < 0.001). No statistical differences were seen in the live birth rates and the time to pregnancy in the four EFI groups. Conclusion: The EFI is predictive of post-operative non-ART pregnancy but not live birth among non-ART pregnancies. ART might be advisable to women with an EFI score <4 immediately after surgery and to women who have not achieved non-ART pregnancy after 12 months despite a high EFI.

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Section: Discussionmentioning

confidence: 99%

Use of endometriosis fertility index to predict non-ART pregnancy and live birth after endometriosis surgery based on optimal stratification

Fan

Kang

et al. 2020

Preprint

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“…Clinical pregnancy was defined as detection of embryonic heartbeat. The rates of implantation, clinical pregnancy, multiple pregnancy, and miscarriage were calculated [8].…”

Section: Controlled Ovarian Stimulation (Cos) and Ivf Proceduresmentioning

confidence: 99%

“…Although the Bologna criteria is useful for predicting ovarian response and counseling purpose, it grouped together women with various pathologies and characteristics [6]. Some have reported that, compared with elder patients, young poor ovarian responders demonstrated higher embryo quality and pregnancy rate but lower miscarriage rate [7][8][9]. Therefore, age has been proposed as an independent predictor for POR [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Some have reported that, compared with elder patients, young poor ovarian responders demonstrated higher embryo quality and pregnancy rate but lower miscarriage rate [7][8][9]. Therefore, age has been proposed as an independent predictor for POR [7,8]. Studies have shown that elder poor responders, in particular those over 40, achieved a significantly lower cumulative live birth rate (CLBR) compared with younger poor responders (< 35) [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Age-Related Decrease of Expression of GDF9 and BMP15 Genes in Follicle Fluid and Granulosa Cells from Poor Ovarian Responders

Gong¹,

Li‐Ling²,

Xiong³

et al. 2020

Preprint

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Background: Growth differentiation factor 9 ( GDF9 ) and bone morphogenetic protein 15 ( BMP15 ) genes play important roles in folliculogenesis. Altered expression of the GDF9 and BMP15 genes have been found among patients with poor ovarian response (POR). In this prospective cohort study, we determined the expression of the GDF9 and BMP15 genes in follicle fluid (FF) and granulosa cells (GCs) from poor ovarian responders grouped by age, and explored its correlation with the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods: A total of 196 patients with POR were enrolled from a tertiary teaching hospital. The patients were diagnosed based on the Bologna criteria and sub-divided into different age groups: group A (< 35 year old), group B (35 ~ 40 year old) and group C (> 40 year old). A GnRH antagonist protocol was conducted for all patients, and FF and GCs were collected after oocyte retrieval. Expression of GDF9 and BMP15 in the FF and GCs was determined with enzyme linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qRT-PCR), and Western blotting. Results: Compared with group C, groups A and B had significantly more transplantable embryos and higher rates of implantation and clinical pregnancy ( P < 0.05). Group A also had significantly more two pronuclei (2PN) oocytes ( P < 0.05). The expression level of GDF9 and BMP15 in the FF and GCs differed significantly among the three groups ( P < 0.05), showing a trend of decline with age. Conclusion: For poor ovarian responders, the expression of GDF9 and BMP15 is declined with increased age in accompany with poorer oocyte quality and IVF outcome, particularly for those over 40.

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“…Поýтому до сих пор не теряет актуальности поиск возможных причин неýффективности программ ЭКО. Одним из приоритетных направлений современной репродуктологии является поиск морфологических, иммуно-гистохимических, молекулярных, генетических и клинических маркеров результативности программ ЭКО [3].…”

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Evaluation of the influence of clinical risk factors on the performance of extracorporal fertilization programs

Лихачева¹,

Маркдорф²,

Bazhenova³

et al. 2018

Bûll. sib. med.

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Purpose of the study. To assess the influence of main clinical risk factors on the effectiveness of the in vitro fertilization (IVF) program.Materials and methods. The study included 3,969 IVF programs conducted in the “Medica” clinic of the “Mother and Child” group of companies in Novokuznetsk for 2010–2015. The inclusion criterion was the availability of information on the results of the procedure conducted.Results.The structure of the considered risk factors was identified, their key features were identified: the majority of women who underwent IVF procedure were under the age of 34, inclusive, more than half of all procedures were performed at the first attempt. The main causes of female infertility were: tubal factor, including those associated with chronic endometritis, polycystic ovary syndrome, external genital endometriosis and adenomyosis. In a number of cases, as a concomitant gynecological disease, uterine fibroids have been extirpated, which is not the main cause of infertility, but the presence of which can influence the effectiveness of IVF programs. Statistically significantly more often, fibroids were found in adenomyosis and tubal factors associated with chronic endometritis. A quantitative assessment of the degree of influence of the considered risk factors on the effectiveness of IVF programs was considered, and the influence of both individual factors and their combination was considered.Conclusion.The main factors statistically significantly increasing the risk of a negative outcome of the program are: the age of a woman over 30; repeated attempt at the age of up to 30 years inclusive (in comparison with the first attempt); tubular factor associated with chronic endometritis; presence of uterine fibroids in the tubular factor associated with chronic endometritis; The presence of fibroids in the tubular factor, complicated by adenomyosis.

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Age, independent from ovarian reserve status, is the main prognostic factor in natural cycle in vitro fertilization

Abstract: NC-IVF is a feasible and "patient-friendly" option to be offered to young patients, independent of their ovarian reserve status.

Cited by 43 publications

References 24 publications

Use of endometriosis fertility index to predict non-ART pregnancy and live birth after endometriosis surgery based on optimal stratification

Use of endometriosis fertility index to predict non-ART pregnancy and live birth after endometriosis surgery based on optimal stratification

Age-Related Decrease of Expression of GDF9 and BMP15 Genes in Follicle Fluid and Granulosa Cells from Poor Ovarian Responders

Evaluation of the influence of clinical risk factors on the performance of extracorporal fertilization programs

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