A low number of retrieved oocytes at in vitro fertilization treatment is predictive of early menopause.
OBJECTIVE
To investigate whether women with a low number of retrieved oocytes at the first in vitro fertilization (IVF) attempt have an increased risk of early menopause.


METHODS
Nested case-control study.


METHODS
Twelve IVF clinics in the Netherlands.


METHODS
Women participating in a nationwide Dutch cohort study (OMEGA) of ovarian stimulation for IVF and subsequent gynecologic diseases (n = 26,428). Each patient who experienced natural menopause at or before 46 years (n = 38) was individually matched to five controls (n = 190) who had not yet entered menopause at the age the patient became postmenopausal.


METHODS
None.


METHODS
Relative risk of reaching natural menopause at an early age (</=46 years), according to the number of retrieved oocytes at the first IVF attempt.


RESULTS
Women with a poor response (zero to three oocytes) had a relative risk of 11.6 (95% confidence interval: 3.9-34.7) of having an early menopause as compared with women who have a normal response (> three oocytes). Women who were stimulated with gonadotropins during IVF treatment but did not undergo an IVF puncture because of an anticipated poor response (canceled IVF cycle) had a relative risk of 8.3 (95% confidence interval: 2.9-23.9).


CONCLUSIONS
These results suggest that women with a low number of retrieved oocytes at the first IVF treatment are more likely to become postmenopausal at an early age than women with a higher number of retrieved oocytes. Our study is the first longitudinal study to provide strong evidence for the quantitative aspect of the ovarian concept of reproductive aging.
de Boer
Evelien J
EJ
Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
den Tonkelaar
Isolde
I
te Velde
Egbert R
ER
Burger
Curt W
CW
Klip
Helen
H
van Leeuwen
Flora E
FE
D000328:Adult; D000375:Aging; D016022:Case-Control Studies; D002452:Cell Count; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008593:Menopause; D009865:Oocytes / Q000166:cytology*; D010062:Ovulation Induction; D011379:Prognosis; D012306:Risk; D020858:Tissue and Organ Harvesting; D017211:Treatment Failure