Ovarian response to standard gonadotrophin stimulation for IVF is decreased not only in older but also in younger women in couples with idiopathic and male subfertility
Authors: Goverde, A.J.; McDonnell, J.; Schats, R.; Vermeiden, J.P.W.; Homburg, R.; Lambalk, C.B.
Source: Human Reproduction, Volume 20, Number 6, 1 June 2005 , pp. 1573-1577(5)
Publisher: Oxford University Press
Abstract:BACKGROUND: With the occasional reports of unexpectedly poor ovarian response to controlled ovarian hyperstimulation (COH) for IVF in young normally cyclic women in mind, we studied age-related ovarian response to COH in a group of women who underwent standard IVF. METHODS: Ovarian response to COH was defined as the number of follicles ≥14 mm on the day of hCG administration. Ovarian response to COH was analysed by multiple regression analysis with woman's age and basal FSH concentration as explanatory variables in a prospective cohort of patients with idiopathic and mild male factor subfertility (n=85), and additionally in a large retrospective cohort of women with unexplained, mild male and tubal subfertility (n=1155), with age as explanatory variable. RESULTS: Ovarian response to COH was associated significantly with age (P<0.001) and basal FSH concentration (P=0.002). However, in women with idiopathic or mild male subfertility, in both cohorts the relationship took the form of an inverted U-shape with both older and—surprisingly—young women having a reduced ovarian response (P<0.001). Maximum ovarian response was around the age of 28 years. In women with tubal infertility, there was only a linear decline of ovarian response with age. CONCLUSION: It is hypothesized that diminished ovarian response to COH in IVF is the very first sign of ovarian ageing in young women diagnosed with idiopathic and mild male subfertility.
Document Type: Research Article
Affiliations: Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
Publication date: 1 June 2005
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