Available Oocytes rate as a predictor of clinical pregnancy outcomes in controlled ovarian stimulation: A retrospective analysis of 7933 Cycles.

Abstract

Controlled ovarian stimulation (COS) and embryo culture may affect the development and maturation of oocytes obtained by assisted reproduction technologies (ART). This study used the concept of available oocytes rate (AOR) to evaluate the effect of COS and to identify factors that influence oocyte development and clinical pregnancy (CP). Medical data of 7933 patients who underwent oocyte retrieval and ART treatments was retrospectively reviewed at Fujian Provincial Maternity and Children's Hospital from January 2013 to December 2019. Baseline characteristics of patients, concentrations of hormones, as well as endometrial thickness, number of aspirated follicles, retrieved and available oocytes, and CP rates, were analyzed. Univariate and multivariate analyses showed that basal estradiol (E2) (OR=0.98, p=0.04), endometrial thickness on human chorionic gonadotropin (hCG)-day (OR=1.25, p<0.01), number of follicles aspirated (OR=1.58, p<0.01), oocytes retrieved (OR=0.80, p=0.04), available oocytes (OR=0.48, p=0.04) and AOR (OR=1.18, p<0.01) contributed to CP. The receiver operating characteristic (ROC) curve for the CP rates showed a possible cutoff for the AOR (area under the curve (AUC)=0.788, cut off=34.13%). All 103 cycles with an AOR less than 34% were then selected as Group-A, and 103 cycles were selected as Group-C by 1:1 case-control matching. The human menopausal gonadotropin (HMG) dose was significantly different between Group-A and Group-C (1064.00±1042.01 U vs. 675.00±691.67 U, respectively, p=0.006). The duration of HMG usage was 7.88±4.73 days in Group-A and 5.79±3.59 days in Group-C (p=0.014). The AOR is an important indicator of oocyte function and is correlated with clinical pregnancy outcomes of fresh cycles. The AOR could objectively predict HMG as a clinically related factor that affected the number and maturation of oocytes for insemination.