Women with regular menstrual cycles and a poor response to ovarian hyperstimulation for in vitro fertilization exhibit follicular phase characteristics suggestive of ovarian aging.
OBJECTIVE
To investigate whether follicular phase characteristics associated with ovarian aging can be observed in women of normal reproductive age, who had previously shown a poor response to ovarian hyperstimulation for IVF.


METHODS
Observational, prospective study.


METHODS
Tertiary fertility center.


METHODS
Eleven regularly cycling, ovulatory women, aged 29-40 years who previously presented with fewer than four dominant follicles after ovarian hyperstimulation for IVF.


METHODS
Frequent serum hormone assessments and transvaginal ultrasound during the follicular phase of a spontaneous, unstimulated cycle.


METHODS
Duration of the follicular phase; serum LH, FSH, E(2), P, inhibin A, and inhibin B levels; and number of antral follicles observed by ultrasound. Results were compared with the cycle characteristics of a reference population of 38 healthy normo-ovulatory women aged 20-36 years (as published elsewhere).


RESULTS
Poor responders had significantly fewer antral follicles than controls. Median FSH concentrations were significantly higher compared with controls, but the majority had FSH levels within the normal range. Follicular phase P levels were significantly higher in poor responders. Duration of the follicular phase, E(2), and inhibin A and inhibin B serum levels did not differ between poor responders and controls.


CONCLUSIONS
Normo-ovulatory regularly cycling women with a previous poor response to ovarian hyperstimulation for IVF show follicular phase characteristics suggestive of ovarian aging.
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.
Nicole G M
NG
Beckers
Nicholas S
NS
Macklon
Marinus J C
MJ
Eijkemans
Bart C J M
BC
Fauser
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000502:physiology*; D006801:Humans; D007265:Inhibins / Q000097:blood; D006080:Ovarian Follicle / Q000502:physiology; D010053:Ovary / Q000502:physiology*; D011446:Prospective Studies
C422364:inhibin B; D007265:Inhibins; D005640:Follicle Stimulating Hormone