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. 2017 Jan;60(1):46-52.
doi: 10.5468/ogs.2017.60.1.46. Epub 2017 Jan 19.

In vitro fertilization outcome in women with diminished ovarian reserve

Bo Hyon Yun  1 , Gieun Kim  1 , Seon Hee Park  1 , Eun Bee Noe  1 , Seok Kyo Seo  1 , SiHyun Cho  2 , Young Sik Choi  1 , Byung Seok Lee  1
Affiliations

In vitro fertilization outcome in women with diminished ovarian reserve

Bo Hyon Yun et al. Obstet Gynecol Sci. 2017 Jan.

Abstract

Objective: This study aimed to identify factors that affect in vitro fertilization (IVF) outcomes in women with diminished ovarian reserve (DOR).

Methods: We reviewed 99 IVF cycles in 52 women with DOR between September 2010 and January 2015. DOR was defined as serum anti-Müllerian hormone level of <1.1 ng/dL or serum follicle-stimulating hormone level of ≥20 mIU/mL. Total 96 cycles in 50 patients were evaluated after excluding fertility preservation cases.

Results: The clinical pregnancy rate was 11.5% per cycle, and the total cancellation rate was 34.4%. Clinical pregnancy rate was significantly associated with the antral follicle count and the cause of the DOR. Age, serum anti-Müllerian hormone and follicle-stimulating hormone levels, antral follicle count, peak estradiol level, and the cause of DOR were significantly associated with cycle cancellation. However, history of previous ovarian surgery remained as a significant factor of clinical pregnancy (model 1: odds ratio [OR] 10.17, 95% confidence interval [CI] 1.46 to 70.84, P=0.019; model 2: OR 10.85, 95% CI 1.05 to 111.71, P=0.045). In cancellation models, idiopathic or previous chemotherapy group showed borderline significance (model 1: OR 3.76, 95% CI 0.83 to 17.04, P=0.086; model 2: OR 3.15, 95% CI 0.84 to 11.84, P=0.09).

Conclusion: DOR caused by previous ovarian surgery may show better pregnancy outcome, whereas that caused by chemotherapy could significantly increase the cycle cancellation rate. Furthermore, patients with DOR who previously received gonadotoxic agents may show reduced efficacy and increased risk of IVF cycle cancellation.

Keywords: Diminished ovarian reserve; Fertilization in vitro.

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Conflict of interest statement

Conflict of interest: No potential conflict of interest relevant to this article was reported.

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