Prognostic value of some ovarian reserve tests in poor responders

2005 ◽  
Vol 272 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Iavor K. Vladimirov ◽  
Desislava M. Tacheva ◽  
Krassimir B. Kalinov ◽  
Aneta V. Ivanova ◽  
Victoria D. Blagoeva
Keyword(s):  
Ovarian Reserve ◽  
Prognostic Value ◽  
Poor Responders

scholarly journals Comparison of IVF Outcomes between Minimal Stimulation and High-Dose Stimulation for Patients with Poor Ovarian Reserve

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tal Lazer ◽  
Shir Dar ◽  
Ekaterina Shlush ◽  
Basheer S. Al Kudmani ◽  
Kevin Quach ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Poor Responders ◽  
High Dose ◽  
Poor Ovarian Reserve

We examined whether treatment with minimum-dose stimulation (MS) protocol enhances clinical pregnancy rates compared to high-dose stimulation (HS) protocol. A retrospective cohort study was performed comparing IVF and pregnancy outcomes between MS and HS gonadotropin-antagonist protocol for patients with poor ovarian reserve (POR). Inclusion criteria included patients with an anti-Müllerian hormone (AMH) ≤8 pmol/L and/or antral follicle count (AFC) ≤5 on days 2-3 of the cycle. Patients from 2008 exclusively had a HS protocol treatment, while patients in 2010 had treatment with a MS protocol exclusively. The MS protocol involved letrozole at 2.5 mg over 5 days, starting from day 2, overlapping with gonadotropins, starting from the third day of letrozole at 150 units daily. GnRH antagonist was introduced once one or more follicles reached 14 mm or larger. The HS group received gonadotropins (≥300 IU/day) throughout their antagonist cycle. Clinical pregnancy rate was significantly higher in the MS protocol compared to the HS protocol (P=0.007). Furthermore, the live birth rate was significantly higher in the MS group compare to the HS group (P=0.034). In conclusion, the MS IVF protocol is less expensive (lower gonadotropin dosage) and resulted in a higher clinical pregnancy rate and live birth rate than a HS protocol for poor responders.

scholarly journals Comparative Effectiveness of Mild or Conventional GnRH-Antagonist Protocols for Ovarian Stimulation in Poor Responders (Poseidon Group 4)

2020 ◽  
Vol 2 ◽  
Author(s):  
Hoang Le ◽  
Dong D. Nguyen ◽  
Anh T. Cao ◽  
Huong T. L. Nguyen ◽  
Dung C. Tham ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Poor Responders ◽  
Research Committee ◽  
Group 4 ◽  
Stimulation Regimen ◽  
Antagonist Protocol

Background and Aims: A panel of experts (the Poseidon Group) introduced a new and more detailed stratification for poor ovarian responders in order to predict the prognosis of IVF outcome according to the sensitivity to FSH. However, various arguments about the management strategy of these patients still remain, including the convenience and the cost. Therefore, this study was conducted to compare the efficacy of mild and conventional GnRH antagonist ovarian stimulation prescribed in patients classified in Poseidon Group 4.Methods: This retrospective cohort study included 359 poor responder patients (Poseidon Group 4) treated with mild or conventional GnRH antagonist stimulation regimens from 8/2017 to 7/2019 at Tam Anh Hospital ART Center. The main outcomes were the index of Follicular Output Rate (FORT) or Follicle to Oocyte Index (FOI), the number of day-2 embryos and top-quality embryos obtained. The t-test and Mann–Whitney U test in SPSS v25.0 was used to analyze the continuous data and Chi-squared/Exact test was used for binary variables. Multiple linear regression analysis was done by using Stata versions 15.0 to measure association between primary endpoints with stimulation regimen controlled for covariates and possible confounding factors.Results: In the overall group of poor responders, the conventional GnRH antagonist protocol performed better than the mild protocol. Subsequently, data were analyzed according to the AFC. In women with AFC < 3, no significant differences were observed between the 2 regimens regarding FORT (p = 0.71), FOI (p = 0.12), the number of day-2-embryos (p = 0.052) and the number of top-quality embryos (p = 0.26). In contrast, in women with AFC ≥ 3, mild stimulation regimen resulted in significantly poorer outcome compared to the conventional GnRH antagonist regimen, regarding FORT (p < 0.01), FOI (p < 0.01), the number of day-2-embryos (p < 0.01) and top-quality embryos (p = 0.01).Conclusions: Considering poor responders classified in Poseidon Group 4, both ovarian stimulation regimens resulted in similar outcome for patients with a very low ovarian reserve (AFC < 3). In contrast, the GnRH conventional antagonist protocol with maximum initial FSH dose (300–375 IU/day) and supplementary LH (75–150 IU/day) was more effective than the mild one for patients whose ovarian reserve was less reduced. The Clinical Trial was approved by the Ethnical Biomedical Research Committee Tam Anh General Hospital.

scholarly journals Association between GnRH Receptor Polymorphisms and Luteinizing Hormone Levels for Low Ovarian Reserve Infertile Women

2021 ◽  
Vol 18 (13) ◽  
pp. 7006
Author(s):  
Shun-Long Weng ◽  
Shu-Ling Tzeng ◽  
Chun-I Lee ◽  
Chung-Hsien Liu ◽  
Chun-Chia Huang ◽  
...  
Keyword(s):  
Luteinizing Hormone ◽  
Ovarian Reserve ◽  
Genetic Variants ◽  
Ovarian Stimulation ◽  
Age Groups ◽  
Recessive Model ◽  
Gnrh Receptor ◽  
Poor Responders ◽  
Nested Case Control ◽  
Control Study

The choice of ovarian stimulation protocols in assisted reproduction technology (ART) cycles for low ovarian reserve patients is challenging. Our previous report indicated that the gonadotrophin-releasing (GnRH) agonist (GnRHa) protocol is better than the GnRH antagonist (GnRHant) protocol for young age poor responders. Here, we recruited 269 patients with anti-Müllerian hormone (AMH) < 1.2 ng/mL undergoing their first ART cycles for this nested case-control study. We investigated the genetic variants of the relevant genes, including follicular stimulating hormone receptor (FSHR; rs6166), AMH (rs10407022), GnRH (rs6185), and GnRH receptor (GnRHR; rs3756159) in patients <35 years (n = 86) and patients ≥35 years of age (n = 183). Only the genotype of GnRHR (rs3756159) is distributed differently in young (CC 39.5%, CT/TT 60.5%) versus advanced (CC 24.0%, CT/TT 76.0%) age groups (recessive model, p = 0.0091). Furthermore, the baseline luteinizing hormone (LH) levels (3.60 (2.45 to 5.40) vs. 4.40 (2.91 to 6.48)) are different between CC and CT/TT genotype of GnRHR (rs3756159). In conclusion, the genetic variants of GnRHR (rs3756159) could modulate the release of LH in the pituitary gland and might then affect the outcome of ovarian stimulation by GnRHant or GnRHa protocols for patients with low AMH levels.

scholarly journals How Can We Predict Success in Poor Responders?

2021 ◽  
Vol 28 (4) ◽  
pp. 361-366
Author(s):  
Alina Elena BORDEA ◽  
◽  
Elvira BRATILA ◽  
Diana MIHAI ◽  
Marina ANTONOVICI ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Poor Responder ◽  
Poor Responders ◽  
The Poor ◽  
Laboratory Techniques ◽  
Reproductive Techniques

Objectives: The aim of this study was to evaluate how can we predict success in poor responder patients in terms of pregnancy rate and live birth rate. Material and method: This study is a review of the newest papers that have in the center the poor responders undergoing treatment involving assisted reproductive techniques (ART). Outcomes: The results show that the most reliable factors when counseling a poor responder patient are age and Anti-Müllerian hormone (AMH) level. Conclusions: The most important factors that influence pregnancy rate are age and ovarian reserve, but other factors such as male pathology and laboratory techniques must be studied deeper.

scholarly journals Predictive Factors for Live Birth in Fresh In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatment in Poor Ovarian Reserve Patients Classified by the POSEIDON Criteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Li ◽  
Tian Ye ◽  
Huijuan Kong ◽  
Jing Li ◽  
Linli Hu ◽  
...  
Keyword(s):  
Live Birth ◽  
Predictive Factors ◽  
Ovarian Reserve ◽  
Inflection Point ◽  
Multivariate Logistic Regression Analysis ◽  
Threshold Effect ◽  
Poor Responders ◽  
Female Age ◽  
Live Births ◽  
Poor Ovarian Reserve

The mechanisms underlying poor ovarian response (POR) in assisted reproductive technology remain unclear, there is no consensus on the management of poor responders, the POSEIDON stratification classifies infertility patients into “expected” or “unexpected” groups to provide a more nuanced picture of POR, but few researchers have discussed the independent predictive factors (smoothed plots and the threshold effect) for live birth in POR patients classified by the new criteria. We conducted a retrospective cohort study using clinical data from 6,580 POR patients classified by the POSEIDON criteria in the First Affiliated Hospital of Zhengzhou University, and explored the live birth based on the results before and after the threshold inflection point of each independent influencing factor. Among 6,580 poor ovarian reserve patients classified by the POSEIDON criteria, 1,549 (23.54%) had live births, and 5,031 (76.46%) did not have live births. Multivariate logistic regression analysis showed that female age (OR 0.901; 95% CI 0.887~0.916; P &lt; 0.001), body mass index (OR 0.963; 95% CI 0.951~0.982; P &lt; 0.001), antral follicle counting (OR 1.049; 95% CI 1.009~1.042; P &lt; 0.001) and controlled ovarian hyperstimulation protocol were independent factors predicting live birth in patients with POR. The threshold effect analysis found that the inflection point of female age was 34 years old, and when age was &gt; 34 years old, the probability of live birth in POR patients dropped sharply (OR 0.7; 95% CI 0.7~0.8; P &lt; 0.001). The inflection point of BMI was 23.4 kg/m2, and BMI had a negative correlation with live birth (OR 0.963; 95% CI 0.951~0.982; P &lt; 0.001). The threshold inflection point of AFC was 8n. Female age, BMI, AFC and COH protocol were independent predictive factors associated with live birth in POR patients classified by the POSEIDON criteria. The smooth curve fit and threshold effect analyses provide clinical management strategies for these patients. In addition, the early-follicular-phase long-acting GnRH-agonist long protocol seems to have a higher live birth rates than other protocols. It is worth highlighting that BMI should be considered as well in the POSEIDON criteria.

scholarly journals Use of Corifollitropin Alfa for Ovarian Stimulation: A Retrospective Analysis of 804 Women Undergoing IVF/ICSI

2019 ◽  
Vol 01 (02) ◽  
pp. 93-98
Author(s):  
Nhu H. Giang ◽  
Lan N. Vuong ◽  
Toan D. Pham ◽  
Tuong M. Ho
Keyword(s):  
Embryo Transfer ◽  
Ovarian Reserve ◽  
Gnrh Antagonist ◽  
Asian Population ◽  
Poor Responders ◽  
Fresh Embryo Transfer ◽  
Corifollitropin Alfa ◽  
Gnrh Antagonist Protocol ◽  
Oocyte Donors ◽  
Antagonist Protocol

Background: Corifollitropin alfa in GnRH antagonist protocol could provide a friendly treatment for IVF patients. There is limited evidence regarding the outcomes of corifollitropin alfa in ovarian hyperstimulation in Asian population. Methods: This was a retrospective study conducted on IVF women from July 2012 to July 2018. The recruited patients were expected normal responders, expected poor responders and oocyte donors. The patients underwent GnRH antagonist protocol with corifollitropin alfa. Results: There were 804 IVF patients included in the study. The patients were analyzed into: normal ovarian reserve-autologous cycles ([Formula: see text] 36 years and [Formula: see text] 60 kg, n = 33; [Formula: see text] 36 years and [Formula: see text] 60 kg, n [Formula: see text] 9; [Formula: see text] 36 years and [Formula: see text] 50 kg, n [Formula: see text] 204; [Formula: see text] 36 years and [Formula: see text] 50 kg, n [Formula: see text] 52), normal ovarian reserve-donor cycles ([Formula: see text] 60 kg, n [Formula: see text] 234; [Formula: see text] 60 kg, n [Formula: see text] 104) and diminished ovarian reserve cycles (n [Formula: see text] 168). In each group of patients, the pregnancy outcomes of fresh embryo transfer were comparable to those of frozen embryo transfer. Conclusions: Corifollitropin alfa could offer an effective and simple treatment option for all groups of patients without PCOS.

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