Early or late response in poor responders: does it make a difference in cycle outcome?

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)
• Ovarian Stimulation Protocols

Background:

• The optimal duration of ovarian stimulation for achieving oocyte maturity in patients with poor ovarian response (POR), as defined by the Bologna criteria, is not well-established in current literature.
• Ovarian response significantly influences the overall length of stimulation required during IVF cycles.

Purpose of the Study:

• To investigate whether a shorter duration of ovarian stimulation (< 9 days) affects the outcomes of IVF cycles in patients diagnosed with poor ovarian response (POR).

Main Methods:

• A retrospective analysis of 267 IVF cycles from patients meeting the Bologna criteria for POR.
• Patients were divided into two groups: Group A (< 9 days stimulation) and Group B (≥ 9 days stimulation).
• Comparison of parameters including antral follicle count, serum estradiol levels, gonadotropin dosage, and oocyte retrieval numbers between the two groups.

Main Results:

• Group B (longer stimulation) showed significantly higher antral follicle count, serum estradiol on hCG day, and total gonadotropin dose compared to Group A.
• The number of total and mature oocytes retrieved was also significantly higher in Group B.
• Despite differences in oocyte yield, no statistically significant difference in pregnancy rates was observed between the shorter (< 9 days) and longer (≥ 9 days) stimulation groups.

Conclusions:

• A shorter duration of ovarian stimulation (< 9 days) does not appear to have a deleterious effect on IVF cycle outcomes in patients with poor ovarian response (POR).
• These findings suggest that individualized stimulation protocols may be feasible for POR patients without compromising pregnancy success.