title: Bone morphogenetic protein-15 in follicle fluid combined with age may differentiate between successful and unsuccessful poor ovarian responders.
abstract: BACKGROUND
  The counselling of poor ovarian responders about the probability of pregnancy remains a puzzle for gynaecologists. The aim of this study was to optimise the management of poor responders by investigating the role of the oocyte-derived factor bone morphogenetic protein-15 (BMP-15) combined with chronological age in the prediction of the outcome of in-vitro fertilisation-embryo transfer (IVF-ET) in poor responders.
  
  
  METHODS
  A retrospective study conducted in a university hospital. A total of 207 poor ovarian responders who reached the ovum pick-up stage undergoing IVF/intracytoplasmic sperm injection (ICSI) with three or fewer follicles no less than 14 mm on the day of oocyte retrieval were recruited from July 1, 2008 to December 31, 2009. Another 215 coinstantaneous cycles with normal responses were selected as controls. The BMP-15 levels in the follicular fluid (FF) of the 207 poor responders were analysed by western blot. Based on the FF BMP-15 level and age, poor responders were sub-divided into four groups. The main outcome measures were the FF BMP-15 level, implantation rate, pregnancy rate, and live birth rate.
  
  
  RESULTS
  The implantation rate (24.2% vs. 15.3%), chemical pregnancy rate (40% vs. 23.7%), clinical pregnancy rate (36.5% vs. 20.4%) and live birth rate (29.4% vs. 15.1%) in the high BMP-15 group were significantly higher than those in the low BMP-15 group. Furthermore, poor responders aged less than or equal to 35 years with a higher FF BMP-15 level had the best implantation, pregnancy and live birth rates, which were comparable with those of normal responders.
  
  
  CONCLUSIONS
  Our study suggests a potential role of BMP-15 in the prediction of the IVF outcome. A high FF BMP-15 combined with an age less than or equal to 35 years may be used as a potential indicator for repeating IVF cycles in poor ovarian responders.
authors.affiliation: Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Yan-Ting
authors.initials: YT
authors.lastname: Wu
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Wang
authors.forename: Xi-Jing
authors.initials: XJ
authors.lastname: Chen
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Zhu
authors.forename: Min-Yue
authors.initials: MY
authors.lastname: Dong
authors.forename: Jian-Zhong
authors.initials: JZ
authors.lastname: Sheng
authors.forename: Chen-Ming
authors.initials: CM
authors.lastname: Xu
authors.forename: He-Feng
authors.initials: HF
authors.lastname: Huang
mesh_terms: D000328:Adult; D000367:Age Factors; D055430:Bone Morphogenetic Protein 15 / Q000032:analysis*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry*; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology / Q000628:therapy; D054315:Oocyte Retrieval; D006080:Ovarian Follicle / Q000033:anatomy & histology / Q000502:physiology; D010053:Ovary / Q000187:drug effects* / Q000503:physiopathology; D010062:Ovulation Induction; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
chemical_list: D055430:Bone Morphogenetic Protein 15