Does preovulatory follicle number affect probability for achievement of at least one top quality embryo from poor responder women undergoing assisted reproduction treatment?

Serkan Kahyaoglu; Hacer Cavidan Gulerman; Nafiye Yilmaz; Inci Kahyaoglu; Yaprak Ustun

Serkan Kahyaoglu Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
Hacer Cavidan Gulerman Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
Nafiye Yilmaz Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
Inci Kahyaoglu Department of Reproductive Endocrinology, Etlik Zubeyde Hanim Women’s Health Hospital, University of Health Sciences, Ankara, Turke
Yaprak Ustun Department of Reproductive Endocrinology, Etlik Zubeyde Hanim Women’s Health Hospital, University of Health Sciences, Ankara, Turke

Keywords: Fertility, Ovarian follicle, Oocyte retrieval, In vitro fertilization, Embryonic development

Abstract

Choosing the ideal treatment protocol based on the prediction of normal, poor, or excessive response might guide clinicians to achieve these treatment goals. Patient-oriented strategies regarding the number of oocytes intended to induce a top-quality embryo (TQE) are needed. We aimed to evaluate the prognostic cycle characteristics for achieving at least one top-quality embryo during ovulation induction among poor responder patients. The medical records of 426 patients with low oocyte yield following controlled ovarian hyperstimulation (COH) treatment for in vitro fertilization-embryo transfer (IVF–ET) procedures between 2008 and 2013 were evaluated. One hundred and thirty-two patients exhibiting poor ovarian response based on the 2011 ESHRE diagnostic criteria were included after exclusion of couples with male factor infertility, endometriosis, chromosomal abnormalities, and any other condition reducing fertility. When the cycle characteristics of women aged ≥35 years were analyzed selectively, a significantly positive correlation has been found between the numbers of >14 mm follicles and generation of top-quality embryos following IVF-ET unlike women <35 years old. Despite the clinical and live birth rates among the two age groups were comparable, the number of >14 mm follicles needed to achieve at least one TQE during COH among ≥35 years old group was determined as 3.5 with a sensitivity of 73% and specificity of 67% (p:0.004). Minimal stimulation protocols might be a reasonable choice for poor responder women younger than 35 years due to a favorable prognosis when compared to older counterparts.

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