Comparative Analysis of Rescue-In Vitro-Maturation (r-IVM) Outcomes in Women with Diminished Ovarian Reserve (DOR) Versus Normal Ovarian Reserve (NOR)

Abstract

Background/Objectives: Diminished ovarian reserve (DOR) poses significant challenges in the reproductive field, resulting in fewer mature and more low-quality eggs. Methods: We studied r-IVM in addition to standard in vitro fertilization (IVF) and compared the embryological outcomes between both DOR and NOR women. Results: We recruited 90 women (45 NOR; 45 DOR) with a younger age seen in NOR (35.2 vs. 36.5 years old) women. Otherwise, DOR women had lower levels of AMH and AFC, thus fewer retrieved follicles and collected oocytes. Most of the group presented with primary subfertility, with 55.6% in the NOR group diagnosed with polycystic ovary syndrome (PCOS), while 37.8% in the DOR group presented with aging and cancer survivorship issues. Most women in the NOR group used hCG as a trigger (82.2%), while 17.8% of the DOR group opted for a decapeptide. A total of 719 oocytes were retrieved, with 72.3% of eggs being mature in the NOR group compared to 64.9% in the DOR group. Following r-IVM, 47.69% of NOR eggs were matured compared to 60% in DOR eggs. The fertilization rates (FRs) following r-IVM were higher in the DOR group (66.7% vs. 37.8%). Overall, higher numbers and quality of D3 embryos were seen in the DOR group. Our analysis revealed that the trigger type, hCG, was the only significant factor linked to successful oocyte maturation rates. Conclusions: Our study suggests that r-IVM may enhance outcomes for women with DOR, including better egg maturity, FR, and embryo quality than NOR women.

Keywords: IVF-ICSI; diminished ovarian reserve; in vitro maturation; oocyte maturation rate; rescue-IVM.

Figure 1

The study flow: group recruitment and IVF outcome.

Figure 2

The rescue-IVM (r-IVM) procedure performed after obtaining immature oocytes.

Figure 3

Embryo quality (EQ) grading based on fragmentation.