Predicting IVF Outcome in Poor Ovarian Responders

Oshrit Lebovitz 1,2 Jigal Haas 1,2 Eran Zilberberg 1,2 Adva Aizer 1,2 Michal Kirshenbaum 1,2 Ravit Nahum 1,2 Raoul Orvieto 1,2
1IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Israel
2Sackler School of Medicine, Tel Aviv University, Israel

Introduction:
Poor responders to ovarian stimulation are one of the most challenging populations to treat. As a failed cycle can cause a considerable emotional and economical loss, adequate fertility counseling addressing patients’ expectations are highly important when facing patients with poor ovarian response.

Aims:
To evaluate reproductive outcomes and to identify factors associated with live birth (LB) after fresh autologous IVF/ intracytoplasmic sperm injection (ICSI) cycles of patients fulfilling the Bologna criteria for poor ovarian response (POR).

Materials & Methods:
A retrospective study included 751 IVF/ICSI treatment cycles which yielded up to three retrieved oocytes, at a tertiary referral hospital between January 2016 to February 2020. A logistic regression analysis was used to adjust for confounders.

Results:
Clinical pregnancy and LB rate per cycle were significantly higher among women younger versus older than 40 years (9.8% and 6.8% versus 4.5% and 2.1%, p<0.01, respectively). Patients who achieved LB were significantly younger, had higher number of oocytes retrieved, fertilization rate and top-quality embryos (P<0.05). Multivariable regression analysis identified patient’s age (OR 0.90; 95% CI 0.845 to 0.97; p=0.005) and mean number retrieved oocytes (OR 1.95; 95% CI 1.20 to 3.16; p= 0.007) as factors significantly associated with the probability of a LB.
Conclusions:
Younger age and higher number of retrieved oocytes were associated with an increased probability of achieving a live birth in poor ovarian responders undergoing IVF treatment.