Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome
BACKGROUND: Poor ovarian response limits IVF success but assessing interventions is difficult because of the wide variation in definition. This study attempts to derive objective definitions of poor response. METHODS: A retrospective study of a consecutive series of 1190 patients aged
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| Veröffentlicht in: | Human reproduction (Oxford) 2004-07, Vol.19 (7), p.1544-1547 |
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| creator | Kailasam, C. Keay, S.D. Wilson, P. Ford, W.C.L. Jenkins, J.M. |
| description | BACKGROUND: Poor ovarian response limits IVF success but assessing interventions is difficult because of the wide variation in definition. This study attempts to derive objective definitions of poor response. METHODS: A retrospective study of a consecutive series of 1190 patients aged |
| doi_str_mv | 10.1093/humrep/deh273 |
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This study attempts to derive objective definitions of poor response. METHODS: A retrospective study of a consecutive series of 1190 patients aged <40 years undergoing their first IVF/ICSI cycle was undertaken. Factors adversely affecting implantation, including advanced female age, were excluded. Clinical outcome in cycles reaching oocyte retrieval (n = 1036) were evaluated with respect to gonadotrophin dose used and oocyte number. Cancelled cycles (n = 154) were analysed in relation to the stimulation dose at cancellation and outcome of their subsequent cycle. RESULTS: Cycle cancellation for patients on ≥300 IU FSH/day compared to those on a lower dose was associated with a significantly worse outcome in the subsequent cycle. If <3000 IU FSH/cycle were administered, clinical pregnancy rates remained favourable if <4 eggs were recovered (29 versus 33% for ≥5 eggs). By contrast, if ≥3000 IU FSH was required, the pregnancy rate was 25% if ≥5 eggs were recovered but declined to 7% if <4 were obtained. CONCLUSIONS: Definitions of poor response should include the degree of ovarian stimulation used. A low oocyte number is only detrimental if the cumulative dose is >3000 IU FSH. Cancellation at ≥300 IU FSH/day is associated with a significantly worse prognosis and could define poor response.</description><identifier>ISSN: 0268-1161</identifier><identifier>ISSN: 1460-2350</identifier><identifier>EISSN: 1460-2350</identifier><identifier>DOI: 10.1093/humrep/deh273</identifier><identifier>PMID: 15142994</identifier><identifier>CODEN: HUREEE</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Aging ; Biological and medical sciences ; Birth control ; definition/gonadotrophins/IVF/poor ovarian response ; Dose-Response Relationship, Drug ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone - administration & dosage ; Follicle Stimulating Hormone - therapeutic use ; Gynecology. Andrology. Obstetrics ; Humans ; Medical sciences ; Oocytes ; Ovary - drug effects ; Ovary - physiology ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sterility. Assisted procreation ; Tissue and Organ Harvesting ; Treatment Outcome</subject><ispartof>Human reproduction (Oxford), 2004-07, Vol.19 (7), p.1544-1547</ispartof><rights>European Society of Human Reproduction and Embryology 2004</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Jul 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-248be19a4f59d82787c26ac37854f509c4bd14598f649fde8a3f97536d3bb193</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15942823$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15142994$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kailasam, C.</creatorcontrib><creatorcontrib>Keay, S.D.</creatorcontrib><creatorcontrib>Wilson, P.</creatorcontrib><creatorcontrib>Ford, W.C.L.</creatorcontrib><creatorcontrib>Jenkins, J.M.</creatorcontrib><title>Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome</title><title>Human reproduction (Oxford)</title><addtitle>Hum. Reprod</addtitle><addtitle>Hum. Reprod</addtitle><description>BACKGROUND: Poor ovarian response limits IVF success but assessing interventions is difficult because of the wide variation in definition. This study attempts to derive objective definitions of poor response. METHODS: A retrospective study of a consecutive series of 1190 patients aged <40 years undergoing their first IVF/ICSI cycle was undertaken. Factors adversely affecting implantation, including advanced female age, were excluded. Clinical outcome in cycles reaching oocyte retrieval (n = 1036) were evaluated with respect to gonadotrophin dose used and oocyte number. Cancelled cycles (n = 154) were analysed in relation to the stimulation dose at cancellation and outcome of their subsequent cycle. RESULTS: Cycle cancellation for patients on ≥300 IU FSH/day compared to those on a lower dose was associated with a significantly worse outcome in the subsequent cycle. If <3000 IU FSH/cycle were administered, clinical pregnancy rates remained favourable if <4 eggs were recovered (29 versus 33% for ≥5 eggs). By contrast, if ≥3000 IU FSH was required, the pregnancy rate was 25% if ≥5 eggs were recovered but declined to 7% if <4 were obtained. CONCLUSIONS: Definitions of poor response should include the degree of ovarian stimulation used. A low oocyte number is only detrimental if the cumulative dose is >3000 IU FSH. Cancellation at ≥300 IU FSH/day is associated with a significantly worse prognosis and could define poor response.</description><subject>Adult</subject><subject>Aging</subject><subject>Biological and medical sciences</subject><subject>Birth control</subject><subject>definition/gonadotrophins/IVF/poor ovarian response</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Fertilization in Vitro</subject><subject>Follicle Stimulating Hormone - administration & dosage</subject><subject>Follicle Stimulating Hormone - therapeutic use</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Oocytes</subject><subject>Ovary - drug effects</subject><subject>Ovary - physiology</subject><subject>Pregnancy</subject><subject>Pregnancy Rate</subject><subject>Retrospective Studies</subject><subject>Sterility. Assisted procreation</subject><subject>Tissue and Organ Harvesting</subject><subject>Treatment Outcome</subject><issn>0268-1161</issn><issn>1460-2350</issn><issn>1460-2350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFvFCEUxonR2O3q0ashJjYeHAsMw0DiRavtNqkaTWMaL4RhmC51BkZgWve_l81M1HiRyyO83_fx8j4AnmD0CiNRHm-nIZjxuDVbUpf3wApThgpSVug-WCHCeIExwwfgMMYbhPKVs4fgAFeYEiHoCty-M5111l3D0fsA_a0KVjkYTBy9iwa2U9g3z7-eQr3TvYkvoXXwzg_GQXVtWviaIrgzKuSGci20KWZxr5LN8q0d4Z1NW5iCUSlLEvRT0ln8CDzoVB_N46WuweXp-8uTTXHx6ez85M1FoWnFUkEobwwWinaVaDmpea0JU7qseZWfkNC0aTGtBO8YFV1ruCo7UVcla8umwaJcg6PZdgz-x2RikoON2vS9csZPUbJ8EM2CNXj2D3jjp-DyaJJgzDlhqM5QMUM6-BiD6eQY7KDCTmIk92HIOQw5h5H5p4vp1Aym_UMv28_A8wVQUau-C8ppG__iBCWc7I1ezJyfxv_-ucxoYzI_f8MqfJesLutKbq6-yS8f3l59PPu8kaL8BX3tsUE</recordid><startdate>20040701</startdate><enddate>20040701</enddate><creator>Kailasam, C.</creator><creator>Keay, S.D.</creator><creator>Wilson, P.</creator><creator>Ford, W.C.L.</creator><creator>Jenkins, J.M.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TM</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20040701</creationdate><title>Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome</title><author>Kailasam, C. ; Keay, S.D. ; Wilson, P. ; Ford, W.C.L. ; Jenkins, J.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-248be19a4f59d82787c26ac37854f509c4bd14598f649fde8a3f97536d3bb193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aging</topic><topic>Biological and medical sciences</topic><topic>Birth control</topic><topic>definition/gonadotrophins/IVF/poor ovarian response</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>Fertilization in Vitro</topic><topic>Follicle Stimulating Hormone - administration & dosage</topic><topic>Follicle Stimulating Hormone - therapeutic use</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Oocytes</topic><topic>Ovary - drug effects</topic><topic>Ovary - physiology</topic><topic>Pregnancy</topic><topic>Pregnancy Rate</topic><topic>Retrospective Studies</topic><topic>Sterility. Assisted procreation</topic><topic>Tissue and Organ Harvesting</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kailasam, C.</creatorcontrib><creatorcontrib>Keay, S.D.</creatorcontrib><creatorcontrib>Wilson, P.</creatorcontrib><creatorcontrib>Ford, W.C.L.</creatorcontrib><creatorcontrib>Jenkins, J.M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kailasam, C.</au><au>Keay, S.D.</au><au>Wilson, P.</au><au>Ford, W.C.L.</au><au>Jenkins, J.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome</atitle><jtitle>Human reproduction (Oxford)</jtitle><stitle>Hum. Reprod</stitle><addtitle>Hum. Reprod</addtitle><date>2004-07-01</date><risdate>2004</risdate><volume>19</volume><issue>7</issue><spage>1544</spage><epage>1547</epage><pages>1544-1547</pages><issn>0268-1161</issn><issn>1460-2350</issn><eissn>1460-2350</eissn><coden>HUREEE</coden><abstract>BACKGROUND: Poor ovarian response limits IVF success but assessing interventions is difficult because of the wide variation in definition. This study attempts to derive objective definitions of poor response. METHODS: A retrospective study of a consecutive series of 1190 patients aged <40 years undergoing their first IVF/ICSI cycle was undertaken. Factors adversely affecting implantation, including advanced female age, were excluded. Clinical outcome in cycles reaching oocyte retrieval (n = 1036) were evaluated with respect to gonadotrophin dose used and oocyte number. Cancelled cycles (n = 154) were analysed in relation to the stimulation dose at cancellation and outcome of their subsequent cycle. RESULTS: Cycle cancellation for patients on ≥300 IU FSH/day compared to those on a lower dose was associated with a significantly worse outcome in the subsequent cycle. If <3000 IU FSH/cycle were administered, clinical pregnancy rates remained favourable if <4 eggs were recovered (29 versus 33% for ≥5 eggs). By contrast, if ≥3000 IU FSH was required, the pregnancy rate was 25% if ≥5 eggs were recovered but declined to 7% if <4 were obtained. CONCLUSIONS: Definitions of poor response should include the degree of ovarian stimulation used. A low oocyte number is only detrimental if the cumulative dose is >3000 IU FSH. Cancellation at ≥300 IU FSH/day is associated with a significantly worse prognosis and could define poor response.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>15142994</pmid><doi>10.1093/humrep/deh273</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aging Biological and medical sciences Birth control definition/gonadotrophins/IVF/poor ovarian response Dose-Response Relationship, Drug Female Fertilization in Vitro Follicle Stimulating Hormone - administration & dosage Follicle Stimulating Hormone - therapeutic use Gynecology. Andrology. Obstetrics Humans Medical sciences Oocytes Ovary - drug effects Ovary - physiology Pregnancy Pregnancy Rate Retrospective Studies Sterility. Assisted procreation Tissue and Organ Harvesting Treatment Outcome |
| title | Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome |
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