Paul De Sutter1, Marc Dhont. 1. Infertility Center, Department of Gynaecology and Obstetrics, University Hospital Ghent, Ghent, Belgium. paul.desutter@rug.ac.be
Abstract
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 MEASURES: 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.
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 MEASURES: 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.
Authors: Efrat Eliyahu; Nataly Shtraizent; Kurt Martinuzzi; Jason Barritt; Xingxuan He; Hong Wei; Sanjeev Chaubal; Alan B Copperman; Edward H Schuchman Journal: FASEB J Date: 2009-12-09 Impact factor: 5.191