Recombinant follicle stimulating hormone stimulation in poor responders with normal basal concentrations of follicle stimulating hormone and oestradiol: improved reproductive outcome

Objective To explore the pregnancy outcomes of embryo transfer with D2 or D3 embryos in patients with poor ovarian response. Methods The pregnancy outcomes of 620 patients who had poor ovarian response and underwent the first in vitro fertilization-embryo transfer (IVF-ET) were retrospectively analyzed. Of the 620 cycles, all available fresh D2 embryos were used in 365 cycles (day 2 embryo transfer) and all available fresh D3 embryos were used in 255 cycles (day 3 embryo transfer) without superfluous embryos for freezing. Results There was a significant difference in clinical pregnancy rate between day 2 (32.73 %) and day 3 (50.83 %) embryo transfer in younger than 35-year-old patients, but no significant differences in implantation rate, live birth rate and spontaneous abortion rate (P>0.05). There were similar pregnancy outcomes between day 2 and 3 embryo transfer in 35-year and older patients. Conclusion D3 embryo transfer may have better pregnancy outcomes in younger than 35-year-old patients with poor ovarian response.

Section: Diagnostic Criteria For Poor Ovarian Responsementioning

confidence: 94%

Day 3 embryo transfer may have better pregnancy outcomes in younger than 35-year-old patients with poor ovarian response

Xin

Jin

et al. 2012

“…In recent years, authors who have tried to define criteria for identifying POR have referred to variables such as: a peak E2 level of <300 pg/ml to <500 pg/ml [6,7], requirement for an increased daily [8] or total gonadotropin stimulation dose [9] or previous cancelled cycle due to a poor response [10]. Although the number of developing follicles and/or the number of oocytes retrieved after a standard dose of ovarian stimulation are two of the most frequent criteria used, the suggested cut-offs have often varied [7,11,12]. Most clinicians prefer to choose the Bless than 4 retrieved oocytes^criteria for predicting POR.…”

Section: Introductionmentioning

confidence: 99%

Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study

Marca

Grisendi

Giulini

et al. 2015

Purpose to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. Methods database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. Results There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. Conclusion The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.

“…A peak E2 level <300 to <500 pg/mL, fewer than 3 to 6 developed follicles, retrieval of fewer than 3 to 5 oocytes, an elevated baseline early follicular serum FSH level, at least 1 cancelled cycle, advanced patient age (≥40 years), and many others have been used to define DOR [14][15][16][17]. Advanced age, abnormal ovarian reserve test results, and DOR previously diagnosed using different parameters are currently the most frequently used criteria in the definition of DOR [18].…”

Section: Introductionmentioning

confidence: 99%

Random anti-Müllerian hormone predicts ovarian response in women with high baseline follicle-stimulating hormone levels

Celik

Bildircin

Güven

et al. 2012

Objective To evaluate the predictive value of random serum anti-Müllerian hormone (AMH) in the assessment of ovarian response in patients with diminished ovarian reserve (DOR; diagnosed after the observation of elevated baseline levels of early follicular follicle-stimulating hormone [FSH]) who were undergoing intracytoplasmic sperm injection-embryo transfer (ICSI-ET) and to compare the random serum AMH and baseline FSH levels in these patients for the prediction of poor ovarian response. Design Retrospective study. Setting University hospital. Patients One hundred and thirty-nine patients who were undergoing ICSI-ET cycles with early follicular FSH level >9 IU/mL. Intervention(s) None. Main Outcome Measure(s) Poor ovarian response in ICSI-ET cycles.Results For the identification of women at risk of cycle cancellation, an AMH cut-off level ≤1.2 ng/mL had 97.3 % sensitivity, 31.3 % specificity, 33.9 % positive predictive value, and 96.9 % negative predictive value in the women with high baseline FSH levels. An AMH cut-off level ≥1 ng/mL had a sensitivity of 58.7 % and specificity of 95.1 % for prediction of retrieval of 4 or more oocytes. By using a serum AMH cutoff level of 1.5 ng/mL, the ongoing pregnancies were predicted with 83.3 % sensitivity and 82.5 % specificity and yielded a positive predictive value of 31.2 % and a negative predictive value 98.1 %. Conclusion Measurement of random serum AMH level is a useful tool in the prediction of ovarian response in patients with high serum early follicular FSH levels.