Poor responders to ovarian hyperstimulation have an increased risk of miscarriage after in vitro fertilization treatment (original) (raw)
Related papers
Miscarriage risk for IVF pregnancies in poor responders to ovarian hyperstimulation
Reproductive BioMedicine Online, 2010
Reproductive BioMedicine Online (2010) 20, 191-200 w w w . s c i e n c e d i r e c t . c o m w w w . r b m o n l i n e . c o m (P = 0.001). Due to interaction, this association became stronger with increasing female age. Among women <36 years, miscarriage rates between poor and normal responders did not differ, whereas among women 36 years poor responders had a statistically significant increased miscarriage rate compared with normal responders (P = 0.001). These results support the hypothesis of a relationship between quantitative ovarian reserve and oocyte quality. RBMOnline
Fertility and Sterility, 2014
Objective: To investigate the association between oocyte number and the rates of ovarian hyperstimulation syndrome (OHSS) and live birth (LB) in fresh autologous in vitro fertilization (IVF) cycles. Design: Retrospective cohort study. Setting: An academic reproductive medicine practice. Patient(s): We analyzed data from 256,381 IVF cycles using the 2008-2010 Society for Assisted Reproductive Technology national registry. Patients were divided into five groups based on retrieved oocyte number. Main Outcome Measure(s): Rates of OHSS and LB were calculated for each group. A generalized estimating equation (GEE) was used to assess differences in OHSS and LB between groups. Receiver operating characteristic (ROC) curves were used to evaluate oocyte number as a predictor of OHSS and LB.
Volume 13, Number 1, Apr-Jun 2019 Pages: 38-44, 2019
Background: In vitro maturation (IVM) is an artificial reproductive technology in which immature oocytes are harvested from the ovaries and subsequently will be matured in vitro. IVM does not require ovarian hyperstimulation (OH) and thus the risk of ovarian hyperstimulation syndrome (OHSS) is avoided. In this study, we assessed the live birth rate per initiated IVM cycle in women eligible for in vitro fertilization/intracytoplasmic sperm injection (IVF/ ICSI) and at risk for OHSS. Furthermore, we followed women who were not pregnant after IVM and committed to a conventional IVF/ICSI procedure. Materials and Methods: In this multicenter prospective cohort study, we started 76 IVM cycles using recombinant follicle stimulating hormone (rFSH) priming in 68 patients. There were 66 oocyte retrievals, in which a total of 628 oocytes were collected. We incubated the immature oocytes for 24-48 hours and fertilized those that reached metaphase II by ICSI. Results: Three hundred eighty six (61% oocytes) achieved metaphase II. The fertilization rate was 55%. We performed 59 embryo transfers (1.9 embryos per transfer) in 56 women, including 3 frozen embryo transfers. There were four ongoing pregnancies (5.3% per initiated cycle) leading to the birth of a healthy child at term. None of the patients developed OHSS. The ongoing pregnancy rate of the first conventional IVF/ICSI cycle after an unsuccessful IVM cycle was 44%, which was unexpectedly high. Conclusion: We concluded that IVM led to live births but with low effectiveness in our study. Earlier reported IVM success rates are higher which can be caused by a more extended experience in these centers with the intricate laboratory process. However, a possible selection bias in these studies cannot be ruled out. Furthermore, IVM might have a beneficial effect on further IVF/ICSI treatments due to its “ovarian drilling” effect.
Journal of International Medical Research
Objective Our objective was to determine whether estradiol (E2) levels (Day 3 and fold change to Day 10), antral follicle count (AFC), and number of ova collected could predict ovarian hyperstimulation syndrome (OHSS) and culdocentesis intervention. Methods We conducted a retrospective review of patient charts between January 2008 and December 2017. OHSS was defined using American Society for Reproductive Medicine criteria. Predictability was evaluated by measuring the area under the receiver operating characteristic curve (AUC). Results The cohort included 319 women (166 controls, 153 OHSS, of whom 54 had severe OHSS). The OHSS group had higher E2Day 3 (249 ± 177 vs. 150 ± 230 ng/L), E2FoldChange (32.2 ± 29.1 vs. 20.1 ± 23.8), AFC (18.2 ± 9.1 vs. 11.6 ± 8.3), and number of ova collected (21.1 ± 9.0 vs. 10.1 ± 6.5). E2Day 3 (AUC = 0.76, 95%CI: 0.71–0.82), E2FoldChange (AUC = 0.71, 95%CI: 0.65–0.77), AFC (AUC = 0.75, 95%CI: 0.70–0.81), and number of ova collected (AUC = 0.85, 95%CI: ...
Fertility and Sterility, 2002
To identify and quantify predictors of poor ovarian response in in vitro fertilization (IVF). Design: Prospective study. Setting: Tertiary fertility center. Patient(s): One hundred twenty women undergoing their first IVF cycle. Intervention(s): Measurement of the number of antral follicles and the total ovarian volume by ultrasound, and of basal levels of FSH, E 2 , and inhibin B on cycle day 3. Main Outcome Measure(s): Ovarian response, and clinical and ongoing pregnancy rates.
International Journal of Reproductive BioMedicine (IJRM)
Background: Poor ovarian reserve and a high rate of pregnancy failure associated with low quality and quantity of oocytes are observed in poor responders to in vitro fertilization. Objective: To assess the effect of age, body mass index (BMI), endometriosis, and history of ovarian surgery on ovarian reserve in a group of poor responders. Materials and Methods: In this cross-sectional study 749 women who referred to Yasmin Clinic of Dr Cipto Mangunkusumo National General Hospital from January 2013 to June 2017 were enrolled. Two definitions of poor responders and Poseidon criteria and consecutive sampling techniques were used. Participants were divided into good and poor responder groups based on the ovarian reserve test; participant with oocyte ≤ 3 was classified as a poor responder. Based on this, 188 participants with nine (4-47) oocytes were included in the poor responder group. While good responder comprised of two (0-3) oocytes. Results: Age and anti-Mullerian hormone level (AM...
Fertility and Sterility, 2000
To evaluate the prognostic significance of low serum E 2 concentrations in controlled ovarian hyperstimulation (COH) cycles for IVF. Design: Retrospective study. Setting: Assisted conception unit of a university hospital. Patient(s): One thousand four hundred and forty patients undergoing COH for IVF. Intervention(s): COH, serum E 2 measurement, ultrasonographic scanning of ovarian follicles, oocyte retrieval, and ET. Main Outcome Measure(s): Cancellation and pregnancy rates. Result(s): Patients were classified into four groups according to serum E 2 levels on the sixth day of COH: group A (E 2 level Ͻ 50 pg/mL [114 cycles]), group B (E 2 level 51-100 pg/mL [189 cycles]), group C (E 2 level 101-200 pg/mL [320 cycles]), and group D (E 2 level Ͼ200 pg/mL [817 cycles]). Group A experienced the highest cancellation rates (65.1%) and lowest pregnancy rates (7.8%) despite requiring significantly more hMG ampules (47.8 Ϯ 1.7). The cancellation rate was higher (75.1%) and no pregnancy occurred in a subset of group A in whom COH was initiated with Ն3 ampules (225 IU) of gonadotropins.
Poor response after hormonal stimulation for in vitro fertilization is not related to ovarian aging
Fertility and Sterility, 2003
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. (Fertil Steril 2003;79:1294 -8.
What is the best predictor of severe ovarian hyperstimulation syndrome in IVF? A cohort study
Journal of Assisted Reproduction and Genetics, 2017
Purpose The purpose of the present study is to study what is the best predictor of severe ovarian hyperstimulation syndrome (OHSS) in IVF. Methods This is a retrospective analysis of all consecutive IVF/intracytoplasmic injection cycles performed during a 5year period (2009-2014) in a single university fertility centre. All fresh IVF cycles where ovarian stimulation was performed with gonadotrophins and GnRH agonists or antagonists and triggering of final oocyte maturation was induced with the administration of urinary or recombinant hCG were analyzed (2982 patients undergoing 5493 cycles). Because some patients contributed more than one cycle, the analysis of the data was performed with the use of generalized estimating equation (GEE). Results Severe OHSS was diagnosed in 20 cycles (0.36%, 95% CI 0.20-0.52). The number of follicles ≥10 mm on the day of triggering final oocyte maturation represents the best predictor of severe OHSS in IVF cycles. The cutoff in the number of follicles ≥10 mm with the best capacity to discriminate between women that will and will not develop severe OHSS was ≥15. Conclusion The presence of more than 15 follicles ≥10 mm on the day of triggering final oocyte maturation represents the best predictor of severe OHSS in IVF cycles.