Email this article Suboptimal response to controlled ovarian stimulation in IVF / ICSI cycles
- Authors: Nguyen C.1, Niauri D.A.1,2, Dzhemlikhanova L.K.1,2, Kogan I.Y.1,2, Krikheli I.O.2, Mekina I.D.2, Lesik E.A.2, Komarova E.M.2, Ishchuk M.A.2, Gzgzyan A.M.1,2
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Affiliations:
- Saint Petersburg State University
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Issue: Vol 69, No 6 (2020)
- Pages: 61-70
- Section: Original Research
- URL: https://journals.eco-vector.com/jowd/article/view/42555
- DOI: https://doi.org/10.17816/JOWD69661-70
- ID: 42555
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Abstract
Hypothesis/Aims of study. Currently, the frequency of suboptimal response (4-9 retrieved oocytes) to controlled ovarian stimulation (COS) in woman is quite high; however, its efficacy is poorly studied. The aim of this study was to evaluate the main characteristics of IVF / ICSI programs in patients with a suboptimal response to COS.
Study design, materials and methods. We performed a retrospective study of 412 IVF / ICSI cycles in women with a suboptimal response to COS, including a comparative analysis of clinical and embryological parameters, ovarian reserve and the efficacy of IVF / ICSI protocols.
Results. Clinical pregnancy rate in ovarian stimulation cycles with a suboptimal response to COS was 27.9%. The efficacy of assisted reproductive technology (ART) programs in women with uterine fibroids was significantly lower than in patients without fibroids (19.1% vs. 30.5%, p = 0.03; OR = 0.54; 95% CI: 0.31-0.95). Clinical pregnancy rate in patients with male factor infertility was significantly higher than in women with anovulation (37.1% vs. 20.9%, р = 0.005; OR = 2.24; 95% CI: 1.27-3.94) or tubal factor infertility (37.1% vs. 24.8%, р = 0.02; OR = 1.79; 95% CI: 1.09-2.94). There were significant correlations between the number of retrieved oocytes with serum anti-Müllerian hormone (AMH) concentration (r = 0.32, p < 0.001) and antral follicle count (AFC) (r = 0.38, p < 0.001). In addition, the need for follicle-stimulating hormone (FSH) preparations during COS correlated significantly with ovarian reserve parameters (AMH and AFC) (r = –0.45 and –0.44, both p < 0.001, respectively) and the age of patients (r = 0.47; p < 0.001).
Conclusion. The clinical pregnancy rate in women with a suboptimal response to COS was low. Concomitant uterine fibroids represented an additional factor of negative influence on IVF / ICSI outcomes in women with a suboptimal response to COS. The male factor of infertility in patients with a suboptimal response did not reduce the efficacy of ART programs. Ovarian reserve parameters in women with a suboptimal response correlated with the need for FSH preparations during COS and the number of retrieved oocytes.
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About the authors
Cong Tuan Nguyen
Saint Petersburg State University
Author for correspondence.
Email: dr.tuan99999@gmail.com
MD, Post-Graduate Student. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty
Russian Federation, Saint PetersburgDariko A. Niauri
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: d.niauri@mail.ru
ORCID iD: 0000-0003-1556-248X
SPIN-code: 4384-9785
MD, PhD, DSci (Medicine), Professor, Head of the Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; Leading Researcher. The Gynecological Department with the Operation Unit
Russian Federation, Saint PetersburgLyailya Kh. Dzhemlikhanova
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: dzhemlikhanova_l@mail.ru
ORCID iD: 0000-0001-6842-4430
SPIN-code: 1691-6559
MD, PhD, Associate Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; the Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgIgor Yu. Kogan
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN-code: 6572-6450
MD, PhD, DSci (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; Director
Russian Federation, Saint PetersburgInna O. Krikheli
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ikrikhely@gmail.com
ORCID iD: 0000-0002-5439-1727
SPIN-code: 7356-6189
MD, PhD, Senior Researcher. The Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgIrina D. Mekina
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ovrt@ott.ru
ORCID iD: 0000-0002-0813-5845
SPIN-code: 4682-8590
PhD, Senior Researcher. The Laboratory of Early Embryogenesis; Senior Embryologist. The Assisted Reproduction Technology Department
Russian Federation, Saint PetersburgElena A. Lesik
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ovrt@ott.ru
ORCID iD: 0000-0003-1611-6318
SPIN-code: 4682-8590
PhD, Senior Researcher. The Laboratory of Early Embryogenesis; Embryologist. The Assisted Reproduction Technology Department
Russian Federation, Saint PetersburgEvgenia M. Komarova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ovrt@ott.ru
ORCID iD: 0000-0002-9988-9879
PhD, Head of the Laboratory of Early Embryogenesis, Embryologist. The Assisted Reproduction Technology Department
Russian Federation, Saint PetersburgMaria A. Ishchuk
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: mashamazilina@gmail.com
MD, Junior Researcher. The Laboratory of Early Embryogenesis, the Department of Assisted Reproductive Technologies, the Department of Reproductology
Russian Federation, Saint PetersburgAlexander M. Gzgzyan
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: agzgzyan@gmail.com
ORCID iD: 0000-0003-3917-9493
SPIN-code: 6412-4801
MD, PhD, DSci (Medicine), Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; Head of the Department of Reproductology, Head of the Department of Assisted Reproductive Technologies
Russian Federation, Saint PetersburgReferences
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