title: High live birth rate in the subsequent IVF cycle after first-cycle poor response among women with mean age 35 and normal FSH.
abstract: Poor ovarian response in IVF cycles is associated with diminished ovarian reserve and poor pregnancy outcome. Little is known about pregnancy outcome after a poor response in women with a normal ovarian reserve. This retrospective study studied women undergoing IVF/intracytoplasmic sperm injection between January 2003 to December 2008 in the FertilityPLUS Clinic in Auckland, New Zealand. All women with a poor response in the first cycle were selected. Primary outcome was live birth after the second cycle. Secondary outcomes were poor response in the second cycle and the predictive values of female age and basal FSH at first cycle and IVF outcome at second cycle. Of the 2487 women starting IVF, 142 women (5.7%) with a poor response in the first cycle were selected, of which 66 (46.5%) women had a repeated poor response in the second cycle. There were 31 live births in the second cycle (21.8%). Female age was the only significant predictor for repeated poor response (AUC 0.69, 95% CI 0.61-0.78) and clinical pregnancy (AUC 0.66, 95% CI 0.57-0.75), but the predictive value was low. Therefore poor response in women with a normal ovarian reserve should not be a reason to discontinue further IVF treatment. Poor ovarian response in IVF cycles is associated with diminished ovarian reserve and poor pregnancy outcome. Little is known about pregnancy outcome after a poor response in women with a normal ovarian reserve. In this retrospective study, we studied women undergoing IVF/intracytoplasmic sperm injection (ICSI) between January 2003 to December 2008 in the FertilityPLUS Clinic in Auckland, New Zealand. All women with a poor response in the first cycle were selected. Primary outcome was live birth after the second cycle. Secondary outcomes were poor response in the second cycle and the predictive value of female age and basal FSH at first cycle and IVF outcome at the second cycle. Of the 2487 women starting wit IVF, a total of 142 women (5.7%) with a poor response in the first cycle were selected, of which 66 (46.5%) women had a repeated poor response in the second cycle. There were 31 live births in the second cycle (22%). Female age was the only significant predictor for repeated poor response and clinical pregnancy, but the predictive value was low. Therefore poor response in women with a normal ovarian reserve should not be a reason to discontinue further IVF treatment.
authors: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. Electronic address: L.M.Moolenaar@amc.uva.nl.
authors: Lobke M
authors: LM
authors: Moolenaar
authors: Seema
authors: S
authors: Mohiuddin
authors: Moira
authors: M
authors: Munro Davie
authors: Margaret A
authors: MA
authors: Merrilees
authors: Frank J M
authors: FJ
authors: Broekmans
authors: Ben Willem J
authors: BW
authors: Mol
authors: Neil P
authors: NP
authors: Johnson
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D050498:Live Birth; D008423:Maternal Age; D010053:Ovary / Q000187:drug effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005640:Follicle Stimulating Hormone
keywords: FSH; IVF; life birth; ovarian reserve; poor response