Differences in ovarian function parameters between Chinese and Caucasian oocyte donors: do they offer an explanation for lower IVF pregnancy rates in Chinese women?

Authors: Gleicher, Norbert; Weghofer, Andrea; Li, JiangMi; Barad, David

Source: Human Reproduction, Volume 22, Number 11, 12 November 2007 , pp. 2879-2882(4)

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Abstract:

BACKGROUND

IVF outcomes in Chinese women are inferior to those of Caucasian patients. Reflecting prematurely diminished ovarian function, women with elevated age-specific baseline (b-) FSH levels are designated to suffer from premature ovarian aging (POA). We investigated if the prevalence of POA differs between these two ethnic populations.

METHODS

We compared patient characteristics and first IVF cycle outcomes in 29 consecutive, Caucasian and 17 Asian-Chinese oocyte donors. POA was diagnosed in a donor if her b-FSH levels exceeded the 95 confidence interval (CI) for her age group.

RESULTS

There was no age difference between Chinese and Caucasian groups (26.2 4.9 versus 25.7 3.1 years, respectively). Chinese women demonstrated, however, a higher cycle cancellation rate (5/17, 29.4), either before cycle start or during stimulation (0/29; relative risk 1.42, 95 CI 1.041.9; P < 0.01), fewer oocytes per initiated cycle (9.3 9.7 versus 15.3 7.1, respectively; P < 0.05) (difference disappeared for only cycles that reached retrieval) and higher b-FSH levels (7.5 1.9 versus 5.1 1.7 mIU/ml, respectively; P 0.004). Nine out of 17 (53) of Chinese and only 1/26 (4) of Caucasian donors met b-FSH level criteria for a presumptive POA diagnosis. Their odds of meeting POA criteria were approximately 30-times greater (odds ratio 31.5; 95 CI 3.518.7; P < 0.0001).

CONCLUSIONS

These data suggest a possible explanation for lower IVF pregnancy rates in Chinese women. Preceding treatment, Chinese women at all ages should be carefully investigated to detect occult POA. Ethnicity may have to be considered an additional outcome variable in fertility studies.

Keywords: fertility treatment; IVF; ethnicity; race; pregnancy rates

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/dem289

Publication date: 2007-11-12

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Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

Differences in ovarian function parameters between Chinese and Caucasian oocyte donors: do they offer an explanation for lower IVF pregnancy rates in Chinese women?

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