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Does ovarian reserve affect outcomes in single ideal blastocyst transfers in women less than 40 years of age?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

There is much debate whether diminished ovarian reserve is purely a quantitative issue, or if quality as determined by pregnancy potential of the ensuing oocytes is also affected. The purpose of this study was to determine whether diminished ovarian reserve, as established by one of three ways described below, affects pregnancy outcomes of women under 40 years old undergoing a single ideal blastocyst transfer.

Materials and methods

This was a retrospective cohort study, including 507 women undergoing an ideal quality single embryo transfer between August 2010 and March 2014. Logistic regression was used to control for age, duration of infertility, parity, body mass index, and smoking status. For analysis, women were stratified for: antral follicle counts (≤ 5 vs. > 5), basal serum FSH levels (< 13 vs. ≥ 13 IU/L), and quartile of total FSH dose required for stimulation.

Results

In stratifying women by antral follicle count (AFC) ≤ 5 vs. > 5, the pregnancy rate (40 vs. 53%, p = 0.04), clinical pregnancy rate (29 vs. 46%, p = 0.02), and live birth rate (13 vs. 43%, p = 0.001) were superior with AFC > 5. Using FSH levels (< 13 vs. ≥ 13 IU/L), the pregnancy rate (50 vs. 31%, p = 0.27), clinical pregnancy rate (40 vs. 13%, p = 0.45), and live birth rate (38 vs. 13%, p = 0.48) were similar. Examining quartiles of FSH stimulation, the pregnancy rates were similar (from lowest to highest: 45, 52, 54, 41%, p = 0.13); however, clinical pregnancy rate (36, 43, 47, 25%, p = 0.003) and live birth rate (32, 38, 44, 20%, p = 0.005) were superior in lower quartiles vs. the highest quartile.

Conclusion

Ovarian reserve may affect embryo pregnancy potential and outcomes when measured by AFC and exogenous stimulation but not by basal FSH levels.

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Abbreviations

FSH:

Follicle stimulating hormone

AFC:

Antral follicle count

GnRH:

Gonadotropin releasing hormone

AMH:

Anti-mullerian hormone

IVF:

In vitro fertilization

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, MUHC Reproductive Centre, 888 Blvd. de Maisonneuve East, Suite 200, Montreal, QC, H2L 4S8, Canada

    Andrew Zakhari, Senem Ates, Talya Shaulov & Michael H. Dahan

  2. 2503 Stallion, St. Lazare, QC, J7T 2E4, Canada

    Andrew Zakhari

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  1. Andrew Zakhari
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  2. Senem Ates
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  3. Talya Shaulov
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  4. Michael H. Dahan
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Contributions

AZ: manuscript writing/editing. SA: manuscript writing/editing. TS: manuscript writing/editing. MHD: protocol/project development, data collection/management, and data analysis.

Corresponding author

Correspondence to Andrew Zakhari.

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Conflict of interest

None of the listed authors have any conflict of interest to declare.

Funding

There was no funding associated with the completion of this project.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Zakhari, A., Ates, S., Shaulov, T. et al. Does ovarian reserve affect outcomes in single ideal blastocyst transfers in women less than 40 years of age?. Arch Gynecol Obstet 297, 233–239 (2018). https://doi.org/10.1007/s00404-017-4571-x

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  • DOI: https://doi.org/10.1007/s00404-017-4571-x

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