Zheng Qiaomei, Li Jie, Chen Shaozhan, Wang Jinhua, Chen Lihong
Fujian Key Laboratory of Precision Medicine for Cancer, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
Department of Gynecology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
J Assist Reprod Genet. 2025 Sep 18. doi: 10.1007/s10815-025-03661-9.
To evaluate the impact of poor ovarian response (POR) on live birth outcomes in endometriosis patients undergoing IVF/ICSI-ET, despite the expected association between reduced oocyte yield and poorer prognosis.
Patients were divided into two groups as endometriosis group (n = 55) and tubal factor group (n = 107). The primary outcomes included clinical pregnancy rate, live birth rate per embryo transfer cycle, and cumulative live birth rate. Secondary outcomes were controlled ovarian hyperstimulation (COH) results and embryo parameters.
The incidence rate of POR increased significantly in endometriosis group (18.9% vs. 5.60%, P < 0.05). Similarly, the number of oocytes retrieved, the number of D3 high quality embryos, and the number of available embryos were fewer in endometriosis group (P < 0.05). However, total number of available embryos, clinical pregnancy rates per transfer cycle, live birth rates per transfer cycle, and cumulative birth rate were found to be similar in both groups (P > 0.05). The presence of POR was found to have no significant impact on the cumulative live birth rate among patients with endometriosis.
While linked to fewer oocytes per cycle, POR does not predict poorer IVF/ICSI-ET outcomes in endometriosis patients. Patient age, not POR or endometriosis itself, is the primary determinant of live birth success. This study challenges the conventional emphasis on oocyte quantity, advocating for a paradigm shift toward individualized, quality-focused ART strategies in endometriosis-related infertility.
评估卵巢反应不良（POR）对接受体外受精/卵胞浆内单精子注射-胚胎移植（IVF/ICSI-ET）的子宫内膜异位症患者活产结局的影响，尽管预期卵母细胞产量降低与预后较差之间存在关联。
将患者分为两组，即子宫内膜异位症组（n = 55）和输卵管因素组（n = 107）。主要结局包括临床妊娠率、每个胚胎移植周期的活产率以及累积活产率。次要结局为控制性卵巢过度刺激（COH）结果和胚胎参数。
子宫内膜异位症组POR的发生率显著增加（18.9%对5.60%，P < 0.05）。同样，子宫内膜异位症组获取的卵母细胞数量、第三天高质量胚胎数量和可用胚胎数量较少（P < 0.05）。然而，发现两组的可用胚胎总数、每个移植周期的临床妊娠率、每个移植周期的活产率和累积出生率相似（P > 0.05）。发现POR的存在对子宫内膜异位症患者的累积活产率没有显著影响。
虽然POR与每个周期的卵母细胞数量减少有关，但它并不能预测子宫内膜异位症患者IVF/ICSI-ET结局较差。患者年龄而非POR或子宫内膜异位症本身是活产成功的主要决定因素。本研究挑战了传统上对卵母细胞数量的重视，主张在子宫内膜异位症相关不孕症中向个体化、以质量为重点的辅助生殖技术策略转变。
