Poor response after hormonal stimulation for in vitro fertilization is not related to ovarian aging.

OBJECTIVE

To investigate whether the diminished efficacy of ART in young poor responders compared to young normal responders is due to a quantitative or a qualitative oocyte factor.

DESIGN

Retrospective comparative analysis.

SETTING

University-based infertility center.

PATIENT(S): Nine thousand six hundred forty-four patients who underwent ART procedures at our hospital from 1993 until 2001.

INTERVENTION(S): Controlled ovarian hyperstimulation, ultrasonographic monitoring of the ovarian response, oocyte retrieval, ART procedure, embryo transfer, and follow-up of pregnant patients until 12 weeks of amenorrhea.

MAIN OUTCOME MEASURES: Clinical rates of pregnancy and miscarriage.

RESULT(S): Nine thousand six hundred forty-four ART cycles were analyzed. The pregnancy rate for poor responders was significantly lower than for normal responders (17% vs. 35%). In cycles in which two good-quality embryos were transferred, the pregnancy rate was similar in poor responders and normal responders (33% vs. 42%). The rate of miscarriage was no higher in poor responders than normal responders.

CONCLUSION(S): Young poor responders have a lower pregnancy rate than young normal responders because they have fewer oocytes, which leads to fewer good-quality embryos to choose from for transfer. The quality of their oocytes and embryos is not inferior to that of normal responders.