UOSD Infertility Unit, ASST Lariana, Como, Italy.
Gynecol Endocrinol. 2022 Sep;38(9):736-741. doi: 10.1080/09513590.2022.2100339. Epub 2022 Jul 17.
To evaluate whether an unexpected poor response (cases with ≤3 oocytes) leads to a reduction in the pregnancy rate in IVF cycles compared to a suboptimal response (controls with 4-9 oocytes) in women with adequate ovarian reserve.
A nested case-control study performed in a retrospective cohort of couples undergoing IVF at the Infertility Unit of the ASST Lariana. Cases and controls had adequate ovarian reserve and were matched 1:1 for female age and number of previous cycles. Cumulative clinical pregnancy rate per oocyte retrieval was the main outcome.
Overall, 113 cases and 113 matched controls were included; the median number of available oocytes was 2 and 6, respectively. The cumulative pregnancy rate per cycle was significantly reduced in cases compared to controls with a crude odds ratio = 0.45 [95% Confidence Interval: 0.28-0.82]. A binomial logistic model indicated that an increase in one oocyte increases the odds for cumulative pregnancy rate per cycle by 1.27 in women with 9 oocytes or less. The cumulative pregnancy rates per cycle in cases and controls, according to female age were respectively: 29% versus 54% in patients aged <35 years ( = 0.036); 22% versus 43% in patients aged 36-39 years ( = 0.048) and 11% versus 13% in patients 40-45 years old ( = 0.72). Patients belonging to older age groups showed decreasing probability of cumulative clinical pregnancy rates both among cases and controls group ( < 0.05).
The number of available oocytes significantly affects the probability of success in IVF cycles with unexpected impaired ovarian response.
评估在卵巢储备功能正常的女性中，与取卵数 4-9 个的卵巢反应欠佳（对照组）相比，取卵数≤3 个的意外不良反应（病例组）是否会导致体外受精（IVF）周期妊娠率降低。
这是一项在 ASST Lariana 不孕科进行的回顾性队列嵌套病例对照研究。病例组和对照组均有足够的卵巢储备功能，且按女性年龄和既往周期数 1:1 匹配。主要结局为每取卵 1 个的累积临床妊娠率。
共纳入 113 例病例和 113 例匹配的对照组；可用卵数中位数分别为 2 个和 6 个。与对照组相比，病例组每个周期的累积妊娠率明显降低，粗比值比=0.45[95%置信区间：0.28-0.82]。二项逻辑回归模型表明，在取卵数 9 个及以下的女性中，每增加 1 个卵，每取卵 1 个的累积妊娠率增加 1.27 倍。根据女性年龄，病例组和对照组的累积妊娠率分别为：<35 岁者 29%比 54%（ = 0.036）；36-39 岁者 22%比 43%（ = 0.048）；40-45 岁者 11%比 13%（ = 0.72）。年龄较大的患者在病例组和对照组中，累积临床妊娠率的可能性均降低（ < 0.05）。
取卵数对卵巢反应不良的 IVF 周期的成功概率有显著影响。
