title: Outcomes of first IVF/ICSI in young women with diminished ovarian reserve.
abstract: BACKGROUND
  There is no consensual definition of diminished ovarian reserve and the best therapeutic strategy has not yet been demonstrated.
  
  
  METHODS
  We performed a retrospective study to evaluate outcomes following a first in-vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) cycle in young women with diminished ovarian reserve. Women with tubal factor, endometriosis or previous stimulation cycle were excluded. We defined diminished ovarian reserve as women ≤38 years with an AMH ≤1.1 ng/mL or antral follicular count ≤7.
  
  
  RESULTS
  Among 59 IVF/ICSI cycles (40% IVF/60% ICSI), the pregnancy rate was 17% (10/59) and live birth rate 8.5% (5/59). Miscarriage rate was 50%. Baseline characteristics and IVF outcomes of the pregnant and not pregnant women were compared. No differences in age, antral follicular count, AMH, protocol used or number of harvested oocytes were found between the groups. A higher gonadotropin starting dose in the pregnancy group (397.5±87 IU vs. 314.8±103 IU; P=0.02) and a trend to a higher total dose received (4720±1349 IU vs. 3871±1367 IU; P=0.07) were noted.
  
  
  CONCLUSIONS
  The present study confirms that women with diminished ovarian reserve have low live birth rates after a first IVF-ICSI cycle and that a higher gonadotropin starting dose might be associated with better outcomes.
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France - drcohenjonathan@gmail.com.|Université Pierre et Marie Curie, Paris, France - drcohenjonathan@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France.
authors.forename: Leonisse
authors.initials: L
authors.lastname: Mounsambote
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France.
authors.forename: Perrine
authors.initials: P
authors.lastname: Prier
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Mathieu d'ARGENT
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France.
authors.forename: Lise
authors.initials: L
authors.lastname: Selleret
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France.|Université Pierre et Marie Curie, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chabbert-Buffet
authors.affiliation: Department of Biology of Reproduction, Tenon Hospital, Pierre et Marie Curie University, Paris, France.
authors.forename: Vanina
authors.initials: V
authors.lastname: Delarouziere
authors.affiliation: Department of Biology of Reproduction, Tenon Hospital, Pierre et Marie Curie University, Paris, France.
authors.forename: Rachel
authors.initials: R
authors.lastname: Levy
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France.|Université Pierre et Marie Curie, Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Darai
authors.affiliation: Department of Gynecology and Obstetrics, Endometriosis Expert Center, Tenon Hospital, Pierre et Marie Curie University, Paris, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Antoine
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006062:Gonadotropins / Q000008:administration & dosage*; D006801:Humans; D065851:Ovarian Reserve; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
chemical_list: D006062:Gonadotropins