Assessment of embryological outcomes in IVF programs for patients of different age groups based on AMH levels

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Abstract

Objective: To evaluate embryological outcomes of IVF programs by examining the number of high-quality blastocysts in relation to AMH levels across different patient age groups.

Materials and methods: A retrospective analysis was conducted on the clinical and laboratory characteristics and results of IVF programs involving 900 patients treated between 2023 and 2024 at the V.I. Kulakov NMRC for OG&P. The mean age of women in the first group was 29.06 (2.85) years, in the second group was 39.01 (1.94) years, and in the third group was 43.03 (1.17) years.

Results: A low number of oocytes (0–5) was consistently observed in women of an advanced reproductive age. A count of 6–10 oocytes was found with equal frequency in both the older and middle-aged groups, while it was less common among younger women, who had a greater number of oocytes (p<0.001). When analyzing the number of MII oocytes, a similar quantity was noted in both the first and second groups, regardless of the total number of oocytes. The most significant finding was the quality of the blastocysts obtained. In the first and second groups, most blastocysts were of excellent or good quality, whereas in the third group, most were of low quality. The analysis of IVF outcomes in subgroups of patients with decreased ovarian reserve revealed that 67% of younger patients and 52% of middle-aged patients produced high-quality blastocysts, whereas no high-quality embryos were obtained from women of advanced reproductive age.

Conclusion: Even with comparable AMH levels in young and older patients, the proportion of high-quality blastocysts significantly declines with age, approaching zero in women over 40. This decline is likely to be associated with oocyte quality, embryo aneuploidy, and impaired development in older patients. In contrast, younger patients can still achieve high-quality embryos despite indicators of decreased ovarian reserve. These findings support the feasibility of conducting IVF programs to achieve pregnancy in younger patients, even when ovarian reserve is reduced.

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About the authors

Tatyana A. Nazarenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: t_nazarenko@oparina4.ru
ORCID iD: 0000-0002-5823-1667

Dr. Med. Sci., Professor, Head of the Institute of Reproductive Medicine

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Nelli A. Khachatryan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_khachatryan@oparina4.ru

PhD, doctor at the F. Paulsen Research and Educational Center for ART with the Clinical Department

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Ekaterina I. Krylova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: kr.katrin00@gmail.com
ORCID iD: 0000-0002-0220-0474

Resident

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Almina M. Biryukova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_birukova@oparina4.ru

PhD, Clinical Supervisor at the F. Paulsen Research and Educational Center for ART with the Clinical Department

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

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Supplementary files

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2. Fig. 1. Age (A) and AMH (B), FSH (C) levels, as well as spermogram categories (D) in comparison groups

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3. Fig. 2. Infertility factors in patients in comparison groups

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4. Fig. 3. The number of OCCs (A) and Mll oocytes (B) in patients in the comparison groups

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5. Fig. 4. Characteristics of blastocyst formation in women in different groups

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