title: Poor ovarian response in patients younger than 35 years: is it also a qualitative decline in ovarian function?
abstract: OBJECTIVE
  To investigate whether poor response to controlled ovarian stimulation (COS) is due to a qualitative decline in ovarian function.
  
  
  METHODS
  This retrospective cohort study included 436 patients younger than 35-years old, undergoing COS for intracytoplasmic sperm injection (ICSI). Patients with four or fewer MII oocytes after COS (poor-responder group, PR, n = 52) were age-matched with normoresponder patients (NR, n = 364).
  
  
  RESULTS
  Although similar duration of stimulation (10.5 +/- 0.4 and 9.3 +/- 0.8 days; p = 0.1358), increased doses of gonadotrophins (2510 +/- 865 and 2253 +/- 572 IU; p = 0.0061) were used in the PR. The results show a increased chance of cycle ending of PR (PR: 26.9% and NR: 3.1%; p < 0.0001). Although the lower total number of oocytes retrieved (2.4 +/- 1.4 and 16.2 +/- 9.3; p < 0.0001), equal rate of fertilization (70.2% and 72.0%, p = 0.1190) and high quality embryos were obtained (50.0% and 45.2%; p = 0.4895), resulting in similar implantation (14.5% and 19.7%; p = 0.2246) and abortion (10.0% and 15.4%; p = 1.00) rates, respectively. A trend towards increased pregnancy rate per embryo transfer in NR group was noted (PR: 26.3% and NR: 42.2%; p = 0.0818).
  
  
  CONCLUSIONS
  Low ovarian response could be associated mainly with a quantitative rather than a qualitative decline in ovarian function. Therefore, even if the ovarian response to stimulation is low, patients aged < or =35 years should process to oocyte retrieval.
authors: Fertility-Assisted Fertilization Center, São Paulo, SP, Brazil.
authors: Rita De Cássia Sávio
authors: Rde C
authors: Figueira
authors: Daniela Paes Almeida Ferreira
authors: DP
authors: Braga
authors: Marcílio
authors: M
authors: Nichi
authors: Camila
authors: C
authors: Madaschi
authors: Luciana
authors: L
authors: Semião-Francisco
authors: Assumpto
authors: A
authors: Iaconelli
authors: Edson
authors: E
authors: Borges
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology; D016009:Chi-Square Distribution; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000097:blood; D010064:Embryo Implantation / Q000502:physiology*; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D054315:Oocyte Retrieval; D009865:Oocytes / Q000502:physiology*; D010053:Ovary / Q000502:physiology*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000187:drug effects*
chemical_list: D006063:Chorionic Gonadotropin; D004958:Estradiol