Live birth rates in Bologna poor responders treated with ovarian stimulation for IVF/ICSI

Abstract

This retrospective study determined the efficacy of ovarian stimulation for IVF/intracytoplasmic sperm injection (ICSI) in poor ovarian responders fulfilling the Bologna criteria for poor ovarian response and identified predictors of live birth rates. Overall, 485 patients undergoing 823 ovarian stimulation cycles for IVF/ICSI with maximum gonadotrophin dose (⩾300IU) between January 2009 and December 2011 were included. Patients were considered eligible, irrespective of the treatment protocol, if they were classified as poor responders based on the recently developed definition for poor ovarian response by the European Society of Human Reproduction and Embryology, the Bologna criteria. Live birth rates did not significantly differ between women aged <40 and women aged ⩾40years either per cycle (7.1 versus 5.2%, OR 1.38, 95% CI 0.77–2.46) or per patient (11.6 versus 8.8%, OR 1.36, 95% CI 0.75–2.46). In logistic regression analysis, the number of oocytes retrieved was the only variable significantly associated with live births (OR 1.92, 95% CI 1.03–3.55 for >3 versus 1–3 oocytes). Bologna poor responders demonstrate very low live birth rates, irrespective of age and treatment protocol used. An increase in the number of oocytes retrieved is an independent variable related to live birth rates.Despite the significant amount of evidence published regarding treatment of women with poor ovarian response, the lack of uniform definition for poor response does not allow firm conclusions regarding the anticipated outcome in these patients. Recently, the European Society of Human Reproduction and Embryology developed new criteria, the Bologna criteria, to describe this population. In this retrospective cohort study, we assessed the live birth rates after treatment with ovarian stimulation for IVF/intracytoplasmic sperm injection in women fulfilling the Bologna criteria. According to our results, Bologna poor responders demonstrate very low live birth rates, irrespective of age and treatment protocol used. An increase in the number of oocytes retrieved is an independent parameter related to live birth rates.