The effect of oocyte reserve and age on the total number of babies born from a given oocyte retrieval

ObjectiveTo determine what negative impact diminished oocyte reserve has on the total number of live babies born from a given oocyte retrieval.DesignRetrospective cohort comparison study.Materials and MethodsAll in vitro fertilization-embryo transfer (IVF-ET) cycles over a 10 year period were selected where the women were < age 42 and where all embryos (both fresh and frozen) were eventually transferred back into the women. 2 groups: normal oocyte reserve (serum FSH <11 mIU/mL) vs. diminished oocyte reserve (FSH >12 mIU/mL). 3 age groups: <35, 36-39, 40-42. Only mild COH was used for those with diminished oocyte reserve.ResultsTabled 1With Diminished Ovarian ReserveAge≤3536-3940-42# retrievals304485433# transfers331519440# deliveries11111540% delivered/transfer33.5%22.2%9.1%% delivered/retrieval (fresh and frozen)36.5%23.7%9.2%# babies delivered14213045Avg. # babies/retrieval0.470.270.10Without Diminished Oocyte Reserve# retrievals1349708406# transfers2138916473# deliveries90230299% delivered/transfer42.2%33.0%20.9%% delivered/retrieval (fresh and frozen)66.9%42.7%24.4%# babies delivered1234390114Avg. # babies/retrieval0.910.550.28 Open table in a new tab ConclusionWomen age <39 with diminished oocyte reserve have about half as many babies born as women with normal reserve despite a closer margin in the category live delivered pregnancy rate per fresh embryo transfer (only 20% less for women aged <35 and 33% less for women 36-39). These data apply when mild stimulation is used for the diminished oocyte group. Based on other studies the difference could be far greater if conventional COH has been used for the diminished oocyte reserve group. The differences were significant (p12 mIU/mL). 3 age groups: <35, 36-39, 40-42. Only mild COH was used for those with diminished oocyte reserve. All in vitro fertilization-embryo transfer (IVF-ET) cycles over a 10 year period were selected where the women were < age 42 and where all embryos (both fresh and frozen) were eventually transferred back into the women. 2 groups: normal oocyte reserve (serum FSH <11 mIU/mL) vs. diminished oocyte reserve (FSH >12 mIU/mL). 3 age groups: <35, 36-39, 40-42. Only mild COH was used for those with diminished oocyte reserve. ResultsTabled 1With Diminished Ovarian ReserveAge≤3536-3940-42# retrievals304485433# transfers331519440# deliveries11111540% delivered/transfer33.5%22.2%9.1%% delivered/retrieval (fresh and frozen)36.5%23.7%9.2%# babies delivered14213045Avg. # babies/retrieval0.470.270.10Without Diminished Oocyte Reserve# retrievals1349708406# transfers2138916473# deliveries90230299% delivered/transfer42.2%33.0%20.9%% delivered/retrieval (fresh and frozen)66.9%42.7%24.4%# babies delivered1234390114Avg. # babies/retrieval0.910.550.28 Open table in a new tab ConclusionWomen age <39 with diminished oocyte reserve have about half as many babies born as women with normal reserve despite a closer margin in the category live delivered pregnancy rate per fresh embryo transfer (only 20% less for women aged <35 and 33% less for women 36-39). These data apply when mild stimulation is used for the diminished oocyte group. Based on other studies the difference could be far greater if conventional COH has been used for the diminished oocyte reserve group. The differences were significant (p