Poor ovarian response in patients younger than 35 years: Is it also a qualitative decline in ovarian function?

被引:19
作者
Savio Figueira, Rita De Cassia [1 ]
Almeida Ferreira Braga, Daniela Paes [1 ,2 ]
Nichi, Marcilio [3 ]
Madaschi, Camila [1 ]
Semiao-Francisco, Luciana [1 ]
Iaconelli, Assumpto, Jr. [1 ]
Borges, Edson, Jr. [1 ,2 ]
机构
[1] Fertil Assisted Fertilizat Ctr, BR-01402001 Sao Paulo, Brazil
[2] Educ & Res Ctr Assisted Reprod, Sapientiae Inst, Sao Paulo, Brazil
[3] Univ Sao Paulo, Dept Anim Reprod, Fac Vet Med & Anim Sci FMVZ, Sao Paulo, Brazil
关键词
ICSI; ovarian stimulation; oocyte retrieval; IN-VITRO FERTILIZATION; HUMAN CHORIONIC-GONADOTROPIN; STIMULATING-HORMONE LEVELS; SERUM ESTRADIOL; IVF; ACTIVATION; AGE; MANAGEMENT; FOLLICLES; PREGNANCY;
D O I
10.1080/14647270902942928
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Objective. To investigate whether poor response to controlled ovarian stimulation (COS) is due to a qualitative decline in ovarian function. Methods. This retrospective cohort study included 436 patients younger than 35-years old, undergoing COS for intracytoplasmic sperm injection (ICSI). Patients with four or fewer MII oocytes after COS (poor-responder group, PR, n = 52) were age-matched with normoresponder patients (NR, n = 364). Results. Although similar duration of stimulation (10.5 +/- 0.4 and 9.3 +/- 0.8 days; p = 0.1358), increased doses of gonadotrophins (2510 +/- 865 and 2253 +/- 572 IU; p = 0.0061) were used in the PR. The results show a increased chance of cycle ending of PR (PR: 26.9% and NR: 3.1%; p < 0.0001). Although the lower total number of oocytes retrieved (2.4 +/- 1.4 and 16.2 +/- 9.3; p < 0.0001), equal rate of fertilization (70.2% and 72.0%, p = 0.1190) and high quality embryos were obtained (50.0% and 45.2%; p = 0.4895), resulting in similar implantation (14.5% and 19.7%; p = 0.2246) and abortion (10.0% and 15.4%; p = 1.00) rates, respectively. A trend towards increased pregnancy rate per embryo transfer in NR group was noted (PR: 26.3% and NR: 42.2%; p = 0.0818). Conclusions. Low ovarian response could be associated mainly with a quantitative rather than a qualitative decline in ovarian function. Therefore, even if the ovarian response to stimulation is low, patients aged <= 35 years should process to oocyte retrieval.
引用
收藏
页码:160 / 165
页数:6
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