Abstract
BackgroundDiminished ovarian reserve (DOR) is one of the most intractable clinical issues in human reproduction and is reported to be associated with raised risk of recurrent pregnancy loss and aneuploid blastocysts. In this study, we aimed to explore whether DOR was also associated with maternal and neonatal complications in in-vitro fertilization/intracytoplasmic sperm injection cycles.MethodsA retrospective cohort study including women below 40 years of age who achieved singleton live birth after fresh embryo transfer in in-vitro fertilization/intracytoplasmic sperm injection cycles in a single center from January 2012 to June 2019 was conducted. Participants with DOR, defined as basal follicle-stimulating hormone (FSH) ≥ 10IU/L and antimullerian hormone (AMH) < 1.2ng/ml, were enrolled as the study group. The controls were 1:2 matched by age and body mass index with FSH < 10IU/L and AMH ≥ 1.2ng/ml. Maternal and neonatal complications were compared between the DOR group and the controls.ResultsA total of 579 women, 193 in the DOR group and 386 matched as controls, were included in this study. Compared to controls, the incidence of hypertensive disorders of pregnancy was significantly increased in the DOR group (5.7% vs. 2.1%, P = 0.021). DOR patients also presented slightly higher incidences of preterm birth (10.9% vs. 7.5%, P = 0.174) and low birthweight (6.2% vs. 5.4%, P = 0.704) yet without statistical significances. The incidences of gestational diabetes mellitus and placenta previa were comparable between the two groups.ConclusionCompared to women with normal ovarian reserve, women with diminished ovarian reserve might have elevated incidence of hypertensive disorders of pregnancy. Patients with diminished ovarian reserve might need more strict antenatal care.
Highlights
According to the American Society for Reproductive Medicine, diminished ovarian reserve (DOR) is defined as women of reproductive age having impaired ovarian reserve and/or poor ovarian response to gonadotropin stimulation [1], clinically characterized by elevated concentration of basal folliclestimulating hormone (FSH), reduced antimullerian hormone (AMH) level as well as declined antral follicle count (AFC)
For DOR patients, the impaired ovarian reserve always leads to fewer oocytes retrieved, less embryos or even no good-quality embryos acquired, which results in poor pregnancy outcomes
Ovarian aging has been correlated with abnormalities in luteal phase function [5], and recent studies demonstrated that luteal phase defect was related to altered maternal vascular health and higher risk of preeclampsia [6, 7]
Summary
According to the American Society for Reproductive Medicine, diminished ovarian reserve (DOR) is defined as women of reproductive age having impaired ovarian reserve and/or poor ovarian response to gonadotropin stimulation [1], clinically characterized by elevated concentration of basal folliclestimulating hormone (FSH), reduced antimullerian hormone (AMH) level as well as declined antral follicle count (AFC). Ovarian aging has been correlated with abnormalities in luteal phase function [5], and recent studies demonstrated that luteal phase defect was related to altered maternal vascular health and higher risk of preeclampsia [6, 7]. It is worth investigating whether the incidences of hypertensive disorders of pregnancy (HDP) and other perinatal complications are elevated among DOR patients. Diminished ovarian reserve (DOR) is one of the most intractable clinical issues in human reproduction and is reported to be associated with raised risk of recurrent pregnancy loss and aneuploid blastocysts. We aimed to explore whether DOR was associated with maternal and neonatal complications in in-vitro fertilization/ intracytoplasmic sperm injection cycles
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